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The Canadian Journal of Urology Jun 2018Each year, varicella-zoster virus (VZV) affects nearly one million people in the United States, often in the form of herpes zoster, or shingles. The urologic system is a... (Review)
Review
INTRODUCTION
Each year, varicella-zoster virus (VZV) affects nearly one million people in the United States, often in the form of herpes zoster, or shingles. The urologic system is a rare but often debilitating target. This paper reviews the epidemiology, symptomatology, diagnosis, and management of VZV as it relates to urologic practice.
MATERIALS AND METHODS
We performed a PubMed search using the query "herpes zoster" and "varicella-zoster virus" combined with multiple urological terms.
RESULTS
Infection caused by VZV, specifically the resurgent clinical infection herpes zoster (HZ), is prevalent and increasing. It often affects older men and women and those in immunocompromised states and usually manifests as a painful cutaneous rash. However, urological conditions such as voiding dysfunction, erectile issues, and flank pain have also been noted in conjunction with an HZ infection. Additionally, urological procedures and treatments may incite an HZ outbreak. Awareness and prompt treatment can ameliorate the intensity and duration of this infection.
CONCLUSIONS
An understanding of the atypical manifestations of HZ and disseminated VZV infection may aid urologic practitioners in avoiding misdiagnosis and delay of treatment.
Topics: Age Factors; Aged; Chickenpox Vaccine; Cohort Studies; Communicable Disease Control; Female; Global Health; Herpes Zoster; Herpesvirus 3, Human; Humans; Male; Middle Aged; Prevalence; Retrospective Studies; Risk Assessment; Severity of Illness Index; Urologic Diseases; Vaccination
PubMed: 29900816
DOI: No ID Found -
GeroScience Dec 2023This systematic review aims to summarize the impact of vaccination against influenza, shingles, and pneumococcus on the incidence on the risk of cardiovascular events in... (Review)
Review
This systematic review aims to summarize the impact of vaccination against influenza, shingles, and pneumococcus on the incidence on the risk of cardiovascular events in the elderly. This protocol was developed in accordance with PRISMA guidelines. We conducted a literature search and identified all relevant articles published regarding the matter up to September 2022. We retrieved 38 studies (influenza vaccine = 33, pneumococcal vaccine = 5, and zoster vaccine = 2). A total of 28 and 2 studies have shown that influenza and pneumococcal vaccines significantly lower the risk of cardiovascular disease in the elderly. Also, repeated influenza vaccination shows a consistent and dose-dependent protective effect against acute coronary syndromes and stroke. Moreover, dual influenza and pneumococcal vaccination was associated with lower risks of some cardiovascular events (stroke, congestive heart failure, ischemic heart disease, and myocardial infarction). However, the impact of PCV13 on cardiovascular events has not been studied, nor has the currently recommended vaccination schedule (PCV13 + PPV23). As for herpes zoster vaccination, only the protective effect against stroke has been studied with the live attenuated herpes zoster vaccine, but no studies have been conducted with the recombinant subunit herpes zoster vaccine. This review outlines the benefits of the vaccines mentioned above beyond their preventive action on infectious diseases. It is intended for health professionals who wish to inform and advise their elderly patients.
Topics: Aged; Humans; Influenza Vaccines; Herpes Zoster Vaccine; Influenza, Human; Incidence; Herpes Zoster; Vaccination; Pneumococcal Vaccines; Stroke
PubMed: 37269492
DOI: 10.1007/s11357-023-00807-4 -
Human Vaccines & Immunotherapeutics Aug 2023This review aimed to estimate the disease burden of herpes zoster (HZ) in China and explore the application of the Grades of Recommendation, Assessment, Development, and... (Meta-Analysis)
Meta-Analysis Review
This review aimed to estimate the disease burden of herpes zoster (HZ) in China and explore the application of the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach in studies of disease burden. We searched for the literature of observational studies analyzing HZ incidence in populations of all ages in China. Meta-analysis models were constructed to calculate the pooled incidence of HZ and pooled risks of postherpetic neuralgia (PHN), HZ recurrence, and hospitalization. Subgroup analysis was performed according to gender, age, and quality assessment score. The quality of evidence for incidence was rated using the GRADE system. Twelve studies with a total of 25,928,408 participants were included in this review. The pooled incidence for all ages was 4.28/1000 person years (95% CI 1.22-7.35). It increased with the increasing in age especially for individuals aged ≥60 y, which was 11.69/1000 person years (95% CI 6.56-16.81). The pooled risks of PHN, recurrence, and hospitalization were 12.6% (95% CI 10.1-15.1), 9.7% (95% CI 3.2-16.2), and 6.0/100,000 population (95% CI 2.3-14.2), respectively. The quality of the evidence assessment of the pooled incidence by the GRADE for all ages was 'low'; however, it was 'moderate' for the ≥60 yold subgroup. HZ is a serious public health problem in China and is more significant in individuals older than 60 y. Therefore, an immunization strategy for the zoster vaccine should be considered. The evidence quality assessment by the GRADE approach indicated that we had more confidence in the estimation of aged population.
Topics: Humans; Incidence; Herpes Zoster; Herpesvirus 3, Human; Neuralgia, Postherpetic; Herpes Zoster Vaccine; China
PubMed: 37424092
DOI: 10.1080/21645515.2023.2228169 -
Clinical Microbiology and Infection :... May 2014Varicella vaccines are highly immunogenic, efficacious and safe in preventing varicella disease. The USA has been the first country recommending universal vaccination.... (Review)
Review
Varicella vaccines are highly immunogenic, efficacious and safe in preventing varicella disease. The USA has been the first country recommending universal vaccination. In the European Union/European Economic Area countries, the use of varicella vaccine is heterogeneous, with some countries recommending universal vaccination in children at national or regional level, others only in high-risk groups and others having no recommendation at all. Uncertainties on the potential impact of varicella vaccination on the epidemiology of varicella and herpes zoster still exist. These uncertainties are the main reason behind the diverse vaccine recommendations. Surveillance systems and mathematical models could be useful to address these uncertainties. However, the lack of surveillance of varicella and herpes zoster in some countries, as well as the high variability of surveillance systems in the countries that have one, makes it difficult to assess the effect of the vaccine. On the other hand, mathematical models are based on assumptions and should be interpreted carefully. Continuous surveillance of varicella and herpes zoster is needed to identify any changes in the epidemiological presentation of the diseases. In any case, continuous surveillance will be needed to fully describe the impact of the programmes currently running and clarify some of the actual uncertainties in the near future. Additionally, increasing our understanding of the risk factors for development of herpes zoster is required.
Topics: Chickenpox; Chickenpox Vaccine; Child; European Union; Herpes Zoster; Herpesvirus 3, Human; Humans; Infant; United States; Vaccination
PubMed: 24494784
DOI: 10.1111/1469-0691.12580 -
CMAJ : Canadian Medical Association... Feb 2012
Topics: Abdomen; Aged, 80 and over; Diagnosis, Differential; Hernia, Abdominal; Herpes Zoster; Humans; Male
PubMed: 22143238
DOI: 10.1503/cmaj.111481 -
The Western Journal of Medicine Dec 1978Herpes zoster is a disorder frequently encountered in adults. The natural history is often poorly appreciated and management is frustrating. Recent studies have...
Herpes zoster is a disorder frequently encountered in adults. The natural history is often poorly appreciated and management is frustrating. Recent studies have critically evaluated newer therapeutic modalities. The epidemiology, clinical manifestations, complications and therapeutic alternatives of herpes zoster deserve review.
Topics: Herpes Zoster; Humans
PubMed: 735044
DOI: No ID Found -
BMJ Case Reports Jun 2013Herpes zoster (HZ) or 'shingles' is a painful vesicular rash resulting from reactivation of the varicella-zoster virus that also causes chickenpox. The incidence of HZ...
Herpes zoster (HZ) or 'shingles' is a painful vesicular rash resulting from reactivation of the varicella-zoster virus that also causes chickenpox. The incidence of HZ infection (HZI) increases with age and the degree of immunosuppresssion. Post herpetic neuralgia, the most common complication of HZ, occurs after the zoster rash has resolved. Conventional therapies include antivirals, corticosteroids and analgesics, both oral and topical. Here we report a case of HZ in an 80-year-old woman involving maxillary nerve and the article also reviews various treatment modalities available for the management of HZI.
Topics: Aged; Aged, 80 and over; Anti-Infective Agents; Drug Therapy, Combination; Female; Herpes Zoster; Humans
PubMed: 23771975
DOI: 10.1136/bcr-2013-010246 -
Human Vaccines & Immunotherapeutics 2014Herpes zoster (HZ) is a common disease among elderly, which may develop into a severe pain syndrome labeled postherpetic neuralgia (PHN). A live-attenuated varicella... (Review)
Review
Herpes zoster (HZ) is a common disease among elderly, which may develop into a severe pain syndrome labeled postherpetic neuralgia (PHN). A live-attenuated varicella zoster virus vaccine has been shown to be effective in reducing the incidence and burden of illness of HZ and PHN, providing the opportunity to prevent significant health-related and financial consequences of HZ. In this review, we summarize the available literature on cost-effectiveness of HZ vaccination and discuss critical parameters for cost-effectiveness results. A search in PubMed and EMBASE was performed to identify full cost-effectiveness studies published before April 2013. Fourteen cost-effectiveness studies were included, all performed in western countries. All studies evaluated cost-effectiveness among elderly above 50 years and used costs per quality-adjusted life year (QALY) gained as primary outcome. The vast majority of studies showed vaccination of 60- to 75-year-old individuals to be cost-effective, when duration of vaccine efficacy was longer than 10 years. Duration of vaccine efficacy, vaccine price, HZ incidence, HZ incidence and discount rates were influential to the incremental cost-effectiveness ratio (ICER). HZ vaccination may be a worthwhile intervention from a cost-effectiveness point of view. More extensive reporting on methodology and more detailed results of sensitivity analyses would be desirable to address uncertainty and to guarantee optimal comparability between studies, for example regarding model structure, discounting, vaccine characteristics and loss of quality of life due to HZ and PHN.
Topics: Cost-Benefit Analysis; Herpes Zoster; Herpes Zoster Vaccine; Humans; Neuralgia, Postherpetic; Quality-Adjusted Life Years; Vaccination
PubMed: 25424815
DOI: 10.4161/hv.28670 -
BMJ Open Mar 2015To examine the prevalence of reported shingles in the last 6 months and its association with post-traumatic stress disorder (PTSD), depression and severity of HIV...
OBJECTIVE
To examine the prevalence of reported shingles in the last 6 months and its association with post-traumatic stress disorder (PTSD), depression and severity of HIV disease in Rwandan women with HIV.
SETTINGS
This cross-sectional study was conducted as part of the Rwanda Women's Interassociation Study and Assessment (RWISA), an observational cohort study designed to assess the impact of HIV and residual factors from experiencing rape in the 1994 genocide in Rwandan women. Participants were recruited through grassroots women's associations of people living with HIV infection and clinical care sites for HIV infection. Most participants (58.5%, n=405/692) had PTSD.
PARTICIPANTS
This cross-sectional analysis was conducted in 710 HIV-infected women enrolled in RWISA. Inclusion criteria were: age >15 years, informed consent, HIV test, ability to complete the interview in the local language, travel to and from the research site and participate in a baseline outpatient visit, and being naive to antiretroviral therapy at enrolment.
PRIMARY AND SECONDARY OUTCOME MEASURES
The outcome of interest was self-reported shingles in the past 6 months. The exposure was PTSD defined using the cross-culturally validated Harvard Trauma Questionnaire.
RESULTS
Overall prevalence of reported shingles in the past 6 months was 12.5% (n=89/710). There was an inverse relationship between shingles prevalence and immunological status: 7.6%, 12.3% and 16.7% of women with CD4 >350, 200-350 and <200 cells/µL, respectively, reported singles (p=0.01). In multivariate analysis, PTSD (aOR 1.7; 95% CI 1.02 to 2.89) and low CD4 (aOR 2.4; 95% CI 1.23 to 4.81) were independently associated with reported shingles in the past 6 months.
CONCLUSIONS
Our study found a significant independent relationship between PTSD and reported shingles, suggesting that PTSD may be associated with immune compromise that can result in herpes zoster reactivation. Further study is needed. It also confirmed previous findings of a strong relationship between shingles and greater immunosuppression in women with HIV infection.
Topics: Adult; CD4-Positive T-Lymphocytes; Cohort Studies; Cross-Sectional Studies; Depression; Female; Genocide; HIV Infections; Herpes Zoster; Humans; Prevalence; Rape; Rwanda; Stress Disorders, Post-Traumatic; Surveys and Questionnaires
PubMed: 25748413
DOI: 10.1136/bmjopen-2014-005506 -
The Journal of Investigative... Dec 2001Varicella-zoster virus (VZV) causes chickenpox (varicella), becomes latent in cranial nerve and dorsal root ganglia, and can reactivate many years later to produce... (Review)
Review
Varicella-zoster virus (VZV) causes chickenpox (varicella), becomes latent in cranial nerve and dorsal root ganglia, and can reactivate many years later to produce shingles (zoster) and postherpetic neuralgia (PHN). Elderly and immunocompromised individuals are also at risk for complications of VZV reactivation involving the central nervous system (CNS), including myelitis, large-vessel encephalitis/granulomatous arteritis, small-vessel encephalitis, meningoencephalitis, and ventriculitis. Peripheral nervous system (PNS) complications range from zoster and postherpetic neuralgia to postinfectious polyneuritis (Guillain-Barre syndrome, GBS). These complications can occur with or without cutaneous manifestations. An increase in elderly and immunocompromised individuals will likely result in a higher prevalence of these conditions; therefore, VZV can be seen as a "re-emerging" infection of the early twenty-first century. In this review, we summarize our experience and the existing literature on CNS and PNS complications of VZV reactivation. Special attention is paid to reports of complications without rash, as these entities are more difficult to diagnose.
Topics: Chickenpox; Herpes Zoster; Herpesvirus 3, Human; Humans
PubMed: 11924825
DOI: 10.1046/j.0022-202x.2001.00041.x