Treatment Of Herpes Zoster Research Articles

Clinical presentation and treatment of herpes zoster and postherpetic neuralgia

Herpes zoster (HZ) is acommon disease caused by reactivation of varicella zoster virus. Diagnosis is usually based on the typical clinical presentation. Standard treatment includes antiviral, topical and analgesic therapies. As acomplication, postherpetic neuralgia (PHN) can result from acute HZ infection, particularly in older and/or immunocompromised people. This can seriously impair the quality of life of those affected and requires adequate analgesia. In addition to the genesis, clinical presentation and treatment recommendations for HZ and PHN, this article also deals in particular with the vaccination prophylaxis recommended by the standing vaccination commission of the Robert Koch Institute (STIKO).

Disproportionality analysis of amenamevir-induced encephalopathy using the Japanese adverse drug event report database

IntroductionAnti-herpesvirus drug-induced encephalopathy can complicate herpes zoster treatment; however, the association between the recently developed anti-herpesvirus drug amenamevir and encephalopathy development remains unknown. Determining the characteristics of amenamevir-induced encephalopathy is essential for potentially improving patient outcomes in the treatment of herpes zoster. The aim of this study is to identify the association between amenamevir treatment and encephalopathy and to determine the risk factors for amenamevir-induced encephalopathy via disproportionality analysis using the Japanese Adverse Drug Event Report (JADER) database. MethodWe conducted a retrospective observational study using anonymized data from the JADER database. Encephalopathy was defined according to the Standardized Medical Dictionary for Regulatory Activities Queries specific to “Noninfectious encephalopathy/delirium.” Disproportionality analysis was used to calculate the reporting odds ratios (RORs) and 95 % confidence intervals (CIs) to assess associations between amenamevir and encephalopathy. Multivariable logistic regression considered age, gender, chronic kidney disease, and cytochrome P450 3A inhibitor use as potential risk factors. ResultsOut of 713,316 patients, 246 were prescribed amenamevir. The median onset of encephalopathy in these patients was 3 days. Disproportionality of encephalopathy was observed in patients treated with amenamevir (ROR, 3.44; 95 % CI, 2.48–4.78). Furthermore, multivariable logistic regression analysis suggested that an age of ≥70 years was associated with amenamevir-induced encephalopathy (ROR, 7.63; 95 % CI, 2.25–25.9). ConclusionThese results suggest that amenamevir treatment may be associated with encephalopathy, particularly in patients aged ≥70 years. Healthcare providers should be aware of this potential risk, especially in elderly patients, to prevent severe central nervous system complications.

Innovative Research on the Integration of Traditional Chinese Medicine and Artificial Intelligence for the Treatment of Herpes Zoster

Herpes zoster is a skin disease caused by the varicella-zoster virus (VZV), primarily manifesting as painful skin rashes in localized areas. Traditional Chinese medicine has a long history of treating herpes zoster, and the integration of modern artificial intelligence (AI) technologies holds promise for further enhancing treatment efficacy. This study aims to construct an AI-based traditional Chinese medicine treatment plan by analyzing large-scale clinical data and traditional medical literature to establish individualized diagnostic models. The experimental results demonstrate that this method effectively shortens the disease course and reduces the incidence of complications. Additionally, the study reveals the mechanisms of action of various components of traditional Chinese medicine in treatment, providing a basis for further optimization of treatment plans. This innovative integration approach not only improves treatment precision but also offers a new paradigm for combined traditional and Western medicine treatment. This paper not only showcases the potential of AI in the field of traditional Chinese medicine but also provides new insights into the treatment of herpes zoster.

An exploratory study of the efficacy and safety of amenamevir for the treatment of herpes zoster in patients receiving immunosuppressive drugs.

Amenamevir is an oral once-daily antiherpesvirus drug that can be administered without dose adjustment in patients with impaired renal function. There are currently no clinical data on immunocompromised patients with herpes zoster treated with amenamevir. Therefore, an exploratory study of the efficacy and safety of amenamevir against herpes zoster in patients with immunosuppression was conducted. Inclusion criteria included patients with acute herpes zoster receiving immunosuppressive drugs or those with malignant tumors or autoimmune diseases. Twenty-four patients were included and received amenamevir (400 mg once daily after meals) for up to 14 days. The primary end point of overall improvement in skin symptoms 7 days after treatment initiation (day 7) was 58.3% for "markedly improved" and 20.8% for "improved." The combined improvement rate was 79.2% (95% confidence interval, 57.8-92.9), and 20.8% of patients experienced "worsened" symptoms. The secondary end points of overall improvement in skin symptoms on day 14 and day 28 were 95.7% and 100%, respectively. The skin symptoms progressed during treatment, peaking on day 7, and then began to heal. By Kaplan-Meier estimation, the median periods to complete crusting and healing were both day 14. There were five adverse events with a possible causal relationship to amenamevir (bacterial skin infection, anemia, hyponatremia, headache, and abnormal liver function) in one of the 24 patients. Although the bacterial skin infection was severe, all events in this patient were reported to be either recovered or recovering. These findings indicate that amenamevir can be effective and safe in immunocompromised patients with herpes zoster. However, as worsening can happen around day 7, it is necessary to carefully monitor such patients and switch to other therapies such as intravenous acyclovir if necessary. Clinical trial identifier: Japan Registry of Clinical Trials jRCTs031190208.

Lymphocyte counts predict optimal timing of chemotherapy reinitiation after antivirus treatment for herpes zoster in children with leukemia.

Herpes zoster (HZ) is rare in healthy children, but more prevalent in those with leukemia. Optimal timing of chemotherapy reinitiation after HZ treatment is challenging because chemotherapy suppresses immunity and increases risk of HZ relapse. We aimed to optimize the timing of chemotherapy reinitiation after HZ therapy in children with leukemia. The study included 31 children with acute leukemia and HZ infection. General information, clinical symptoms, laboratory test results, duration of HZ treatment, and prognosis were compared with those of children with leukemia alone. Correlation analysis was performed for 20 children who restarted chemotherapy after HZ treatment. Of 31 children with leukemia and HZ, 67.74% had lesions at multiple sites. The median time from chemotherapy initiation to HZ onset was 14.1 (1.5-29.5) months. Among 27 children included in the follow-up, there was one case of HZ relapse. After excluding children who did not continue chemotherapy after HZ treatment, the median interval between completion of HZ therapy and chemotherapy reinitiation in the remaining 20 children was 8.00 (-3 to 27) days. Lymphocyte counts (LY#) on restarting chemotherapy correlated inversely with HZ lesion healing time (p < 0.05). LY# at the time of HZ onset were lower than those pre- and post-onset, and lower than those in the control group (p < 0.05). In conclusion, children with leukemia have a good HZ prognosis, but an increased risk of HZ recurrence. LY# at the time of chemotherapy reinitiation may be a useful indicator for selecting the optimal interval between antiviral therapy completion and chemotherapy reinitiation.

Ji Desheng Snake Medicine for Herpes Zoster

Objective: to evaluate the clinical efficacy and application value of Ji Desheng snake medicine in the treatment of herpes zoster by Meta-analysis. Methods: CNKI, WANFANG, VIP, PubMed, The Cochrane Library and Embase were searched to identify available articles (up to January 2024). The included articles were subjected to data extraction and bias risk evaluation, and ＲevMan5.3 software was used to evaluate the efficacy and safe recovery time. Results: Nine articles involving 459 patients were finally included. Meta-analysis showed that Ji Desheng snake medicine combined with conventional treatment could improve and shorten the disease recovery time of patients [MD = − 3.30, 95%CI (-5.50, -1.1%), P &lt; 0.05]. Ji Desheng snake medicine combined with routine treatment tended to improve the curative effect, and the difference was not statistically significant [RR = 1.11, 95%CI (0.99, 1.24), P = 0.12]. Conclusion: Ji Desheng snake medicine combined with conventional antiviral therapy can shorten the course of herpes zoster, suggesting that the combination of Ji Desheng snake medicine and conventional antiviral drugs should be considered in the clinical treatment of herpes zoster. However, due to the large differences in the included literature, we should treat the research results carefully, and large sample size and high-quality literature are needed to further confirm its clinical efficacy.

The Clinical Effect of External Application of Scorzonera Glabra Herpes Ointment on the Treatment of Herpes Zoster in the Ear

Objective To Exploring the effect of external application of scorzonera glabra Herpes Ointment on the treatment of Herpes zoster of the ear (HZE). Methods Select 100 HZE patients who met the inclusion criteria and were treated at the 988th Hospital of the Chinese People's Liberation Army Joint Logistics Support Force from January 2021 to June 2023. Divide into a treatment group and a control group using a random number table method, with 50 cases in each group. The treatment group was treated with external application of crow onion herpes ointment, while the control group was treated with external application of acyclovir ointment. After 10 days of treatment, the therapeutic effect was evaluated, and the HZE comprehensive symptom and sign efficacy score and visual analogue scale (VAS) were observed and compared between the two groups on the 10th day. The time for erythema reduction, blister stop, nodulation, and detachment were observed throughout the treatment process; Compare the difference in air conduction and air bone conduction between two groups before and after treatment (1 month after treatment); Observe and compare the incidence of postherpetic neuralgia (PHN) between two groups one month after treatment. Results The difference between the two groups was statistically significant (P&lt;0.05), and the clinical effect of the treatment group was significantly better than that of the control group. Compared with the control group, the total score of HZE symptoms and signs in the treatment group was lower, and the difference was statistically significant (P&lt;0.05). The comparison of air conductance between the treatment group and the control group before and after treatment (1 month after treatment) showed that the average air conductance was (35.5 ± 4.5), (35.9 ± 4.7), (15.6 ± 2.2), and (21.0 ± 3.1) dBHL, respectively; The air bone conduction differences were (10.1 ± 2.7), (10.5 ± 2.8), (5.1 ± 0.3), and (10.0 ± 2.4) dBHL, respectively. The differences in air conduction between the two groups before and after treatment (1 month after treatment) were statistically significant (P&lt;0.05); The difference in air bone conduction between the two groups before and after treatment (1 month after treatment) was statistically significant (P&lt;0.05); However, there was no statistically significant difference in air bone conduction difference between the control group before and after treatment (P&gt;0.05). The incidence of PHN in the treatment group was lower than that in the control group, and the difference was statistically significant (P&lt;0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P&gt;0.05). Conclusion The external application of scorzonera glabra Herpes Ointment has a significant effect on treating HZE, and can shorten the course of the disease, improve hearing, restore the function of the auditory nerve, and effectively prevent PHN.

Differentiation and Treatment of Herpes Zoster from “Opening Xuanfu”

Differentiation and Treatment of Herpes Zoster from “Opening Xuanfu”

Exploring Drug Repurposing Through Artificial Intelligence: A Novel Approach to Treating Herpes Zoster Infection

Abstract Background: This study evaluates the potential of ChatGPT, an artificial intelligence (AI) language model, to assist health-care professionals in selecting appropriate medications for the management of herpes zoster. Agroup of experts specializing in dermatology and infectious diseases assess the recommendations provided by ChatGPT for ten hypothetical clinical scenarios involving herpes zoster. Aims and Objectives: The main objective is to determine the extent to which ChatGPT can contribute to informed decision-making when it comes to repurposing drugs for the treatment of this condition. Materials and Methods: The accuracy and relevance of ChatGPT’s suggestions are evaluated by comparing them to current medical research and literature. Results: The findings indicate that ChatGPT consistently offers valuable recommendations for potential drug repurposing in the management of herpes zoster, aligning with scientific evidence and published literature. While there may be limitations in terms of therapeutic options and the inability to customize treatment plans, health-care professionals find ChatGPT’s guidance beneficial in identifying potential repurposed drugs. However, it is important to address these limitations, such as the need for more clinical data and the ability to customize treatment plans. Further research is necessary to enhance ChatGPT’s effectiveness in managing herpes zoster. Conclusion: Future studies should focus on refining the model’s capabilities, incorporating comprehensive clinical data, and enabling customization of treatment plans to make ChatGPT a valuable resource for health-care professionals dealing with herpes zoster.

Herpes Zoster Granulomatous Dermatitis: A Rare but Memorable Complication

There have been reports of benign and cancerous cutaneous reactions developing at the site of resolved herpes zoster weeks to years after the acute infection. This case study describes a 71-year-old male patient with herpes zoster granulomatous dermatitis, a manifestation of postherpetic isotopic response. His medical history was significant for Graves' disease and chronic myelomonocytic leukemia. After presenting to the emergency department, he was diagnosed with herpes zoster generalisatus. Approximately two months after receiving treatment for herpes zoster, multiple firm subcutaneous nodules appeared on his neck. An excisional biopsy was performed to rule out leukemia cutis. The specimen displayed extensive dermal lymphohistiocyte infiltration, marked by central necrosis and atypical T cells. Tests for tuberculosis and leukemia were negative. At follow-up, an excisional biopsy of the recurrent neck nodules confirmed diffuse dermal infiltration and central necrosis. Based on the clinical and pathological findings, he was diagnosed with herpes zoster granulomatous dermatitis. He was administered systemic and topical steroid therapy over one month, after which the lesions and associated symptoms improved. Wolf's isotopic response refers to the occurrence of a new skin disease at the site of an already healed, unrelated skin disease. This phenomenon is frequently overlooked—especially following herpes zoster. Healthcare practitioners should know Wolf's isotopic response to ensure accurate diagnosis and avoid potential oversight of malignant diseases.

Value of Chuanjin Qinggan decoction in improving the depressive state of patients with herpes zoster combined with depression.

Western medicine is beneficial for the recovery of neurological function in patients with depression, but some patients experience side effects such as headaches, dizziness, nausea, gastrointestinal symptoms, insomnia, and cardiac dysfunction. In recent years, integrative medicine has achieved positive results in the treatment of various diseases. To study Chuanjin Qinggan decoction combined with selective serotonin reuptake inhibitors (SSRIs) in patients with herpes zoster complicated by depression. Patients with herpes zoster complicated by depression who were treated at the Yantai Hospital of Traditional Chinese Medicine from January 2021 to December 2022 were retrospectively selected as research participants. Among them, 43 patients with herpes zoster complicated by depression who received SSRI treatment between January and December 2021 were assigned to the Western medicine group, while those who received combined treatment of traditional Chinese and Western medicine between January and December 2022 were assigned to the combined group. Both groups were treated for eight weeks. The degree of pain, effect of herpes zoster treatment, degree of improvement in depressive symptoms, serum neurotransmitter levels, sleep quality, and occurrence of adverse reactions were compared between the two groups. We found that after eight weeks of drug treatment, the two treatment schemes achieved differing efficacy. In further comparison, we found that, compared with patients treated with SSRIs alone, patients treated with Chuanjin Qinggan decoction combined with SSRIs showed more significant improvement in depression and a greater increase in dopamine and 5-hydroxytryptamine levels after treatment (P < 0.05). Patients treated with Chuanjin Qinggan decoction combined with SSRIs also experienced lower pain, better treatment efficacy for herpes zoster, better sleep quality, and a lower incidence of adverse reactions compared to those treated with SSRIs alone (P < 0.05). All minor adverse reactions occurring during treatment were resolved after symptomatic treatment. The treatment scheme of Chuanjin Qinggan decoction combined with SSRIs can improve the psychological state of patients with herpes zoster complicated by depression and alleviate adverse reactions.

Prospects for the use of Lipster Mint cream in the complex treatment of herpes zoster

Objective — to investigate the clinical efficacy of Lipster Mint cream in the complex treatment of patients with herpes zoster. &#x0D; Materials and methods. The study included 15 patients (11 women and 4 men) with acute herpes zoster. The age of the patients ranged from 38 to 70 years. The patients had severe clinical symptoms (typical vesicular rash, itching of varying intensity, burning sensation, intense pain along the affected nerves and sleep disturbance). The localization of pathological foci was unilateral: in 12 patients on the skin of the trunk, in 1 patient on the buttock and in 2 patients on the skin of the thigh. All patients reported a decrease in quality of life due to the disease. The complex treatment included Valavir, one of the valacyclovir drugs, according to the recommended regimens, which was administered orally in 1000 mg tablets three times a day for 7 days. Acute herpes-associated pain and heartburn were relieved with analgesics and topical application of Lipster Mint cream, manufactured by Farmak (Ukraine), which contains acyclovir 5 % and menthol. A distinctive advantage of Lipster Mint is that it contains the highest dose of acyclovir permitted for topical products — 5 %, as well as menthol which cools and reduces itching. The effectiveness of treatment of herpes zoster was assessed by the dynamics of clinical symptoms and subjective feelings on the 2nd, 5th and 10th days of treatment. &#x0D; Results and discussion. As a result of the treatment, positive dynamics of all clinical manifestations was achieved. Inflammatory phenomena such as swelling and hyperemia of the skin significantly decreased, the appearance of fresh herpes rash stopped within 24 hours, body temperature normalized on the 2—3rd day, general condition improved, pain and discomfort in the affected areas significantly decreased, partial epithelialization of erosions and the appearance of crusts were observed on the 5—7th day. With the topical application of Lipster Mint, under the influence of menthol, from the first minutes of application, patients significantly reduced the sensations of burning, tingling and pain in the areas of skin lesions. &#x0D; Conclusions. Despite the available arsenal of specific and non-specific antiherpetic drugs, treatment of patients suffering from herpes zoster continues to be an urgent medical problem that requires further improvement and individualized approach. Our clinical observations indicate the effectiveness of the systemic drug Valavir and the topical drug Lipster Mint cream in the complex treatment of herpes zoster, which makes it possible to reduce postherpetic neuralgia in the areas of skin lesions and improve the quality of life of patients.

Herpes Zoster and COVID-19 Vaccination: A Narrative Review.

COVID-19 was a worldwide emergency, leading to a global health crisis, which completely revolutionized every aspect of human life. Several strategies were adopted to limit the spreading of the infection such as testing and contact tracing, quarantine and isolation, use of face mask, social distancing, lockdowns, travel restrictions, etc. Of these, vaccines were the most important measures to reduce the transmission of the virus and the severity of the infection, in order to overcome the pandemic. Fortunately, vaccination campaign was a success, showing to be efficient in controlling and preventing the COVID-19, reducing the risk of disease progression, hospitalization, and mortality. Monitoring and addressing vaccine-related adverse events have been essential for maintaining public confidence. Indeed, with the increasing number of vaccines administered, various cutaneous reactions have been reported, making dermatologists key players in their recognition and treatment. Particularly, several cutaneous diseases and cutaneous findings have been reported. Of note, also viral reactivations have been described following COVID-19 vaccination. Among these, varicella zoster virus (VZV) reactivation has been collected. Globally, an early diagnosis and an accurate treatment of herpes zoster (HZ) is mandatory to reduce possible complications. In this context, we conducted a review of the current literature investigating cases HZ following COVID-19 vaccination with the aim of understanding the possible causal correlation and underlying pathogenetic mechanisms to offer clinicians a wide perspective on VZV reactivation and COVID-19 vaccines.

Nursing interventions based on the theory of syndrome differentiation in the treatment of herpes zoster

Nursing interventions based on the theory of syndrome differentiation in the treatment of herpes zoster

Comparison of efficacy of acupuncture-related therapy in the treatment of herpes zoster: A network meta-analysis of randomized controlled trials.

A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to evaluate the efficacy and safety of acupuncture-related therapy in the treatment of herpes zoster (HZ) and to provide a reference for the clinical treatment of herpes zoster. PubMed, Cochrane Library, EMBASE, Web of Science, CNKI, VIP database, Wanfang Database, and SinoMED Chinese and English databases were systematically searched for RCTs on acupuncture-related therapy for HZ until February 2023. Literature screening, data extraction, and risk of bias assessment were performed independently by 2 researchers. R4.2.1 and Stata15.1 software were used for data analysis. A total of 26 RCTs involving 1929 HZ patients were included, and the network meta-analysis results showed that acupotomy appeared to be most effective in terms of improving VAS scores and the time of incrustation; SUCRA cumulative probability ranking showed the best efficacy of bloodletting in improving efficiency and the time of ceasing new blisters, acupuncture in improving the time of decrustation, and moxibustion in reducing the incidence of postherpetic neuralgia (PHN). Through a comprehensive comparison of 9 different acupuncture therapies, acupotomy was the optimal treatment to improve VAS pain scores and the time of incrustation; bloodletting, acupuncture, fire needle, and moxibustion could be effective intervention measures to improve the time of ceasing new blisters and decrustation and reduce the incidence of PHN; Western medicine was closely related to adverse reactions. The conclusions need to be further verified due to the limitations of the study.

Formulation Optimization and Evaluation of Nanocochleate Gel of Famciclovir for the Treatment of Herpes Zoster.

Herpes zoster is a viral infection triggered due to the reactivation of the varicella- zoster virus in the posterior dorsal root ganglion. Herpes zoster infections occur mostly in the facial, cervical and thoracic regions of the body, beginning with pain and resulting in the vesicular eruption. Recently, this infection was observed during the COVID-19 pandemic and also after the induction of mRNA-based vaccine for coronavirus at an extended level. Nanocochleates are cylindrical (cigarshape) microstructure lipid-based versatile carriers for drug delivery systems. Famciclovir is an antiviral agent employed for the treatment of Herpes zoster infections. The current research patent aims to develop a novel nanocochleate gel of Famciclovir for the treatment of herpes zoster infections with higher efficacy. The interaction studies using FTIR were carried out and indicated no such interactions between the drug and lipids. The nanocochleates were developed using hydrogel, trapping, liposome before cochleate dialysis, direct calcium dialysis and binary aqueous-aqueous emulsion methods, respectively. The 32 Box-Behnken design was applied by considering the concentration of lipids (phosphatidylcholine and cholesterol) and speed of rotation as independent factors, whereas particle size and entrapment efficiency as dependable factors. The developed nanocochleates were estimated for the particle size (276.3 nm), zeta potential (-16.7 mV), polydispersity index (0.241), entrapment efficiency (73.87±0.19%) and in vitro diffusion release (>98.8% in 10 h). The optimized batch was further converted into the topical gel using carbopol 940 as a gelling agent. The prepared gel was smooth, rapidly spreadable with a viscosity (5998.72 cp), drug content (95.3%) and remained stable during stability studies. A novel nanocochleate gel of Famciclovir was successfully developed for the treatment of infections associated with Herpes Zoster with sustained release action.

Clinical efficacy of LED golden light combined with acyclovir in the treatment of herpes zoster: a single-center prospective study

Clinical efficacy of LED golden light combined with acyclovir in the treatment of herpes zoster: a single-center prospective study

#4815 COMPARISON OF DIFFERENT ANTIVIRALS REGARDING THEIR ASSOCIATION WITH HOSPITAL-ACQUIRED ACUTE KIDNEY INJURY AMONG ADULTS WITH HERPES ZOSTER

Abstract Background and Aims Antiviral therapy is commonly used to treat herpes zoster. Though antivirals are generally considered nephrotoxic, few studies compared the relative risk of acute kidney injury in patients with herpes zoster that is attributable to different antivirals. We aim to examine the association of use of different antivirals with hospital-acquired acute kidney injury (HA-AKI) among Chinese adults with herpes zoster. Method The study population was derived from the China Renal disease System (CRDS), a retrospective cohort of hospitalized patients from 19 medical centers throughout China. We selected from CRDS 3,847 adults who received antiviral therapy for herpes zoster during hospitalization. We identify and stage AKI using patient-level serum creatinine data according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. We compared the relative risks of HA-AKI among patients treated with different antivirals using Cox proportional hazards model, and explored the non-linear association between the accumulative dose of antivirals and the risk of HA-AKI using a penalized smoothing spline. Results Among 3,847 patients, 1,585 (41.2%), 699 (18.2%), 599 (15.6%) and 964 (25.1%) were treated with acyclovir/valacyclovir, ganciclovir, penciclovir/famciclovir, and foscarnet, respectively. The incidence of HA-AKI was 4.9%, 2.9%, 2.8% and 0.8%, respectively, in the patients treated with acyclovir/valacyclovir, ganciclovir, penciclovir/famciclovir, and foscarnet. Compared with acyclovir/valacyclovir therapy, use of foscarnet was associated with a 69% reduction in the risk of HA-AKI (hazard ratio [HR], 0.31; 95% confidence interval [CI], 0.14-0.66), while use of other nucleoside analogues was associated with a marginally lower risk of HA-AKI, with a HR (95% CI) of 0.62 (0.36-1.09) for penciclovir/famciclovir and 0.67 (0.41-1.11) for ganciclovir. When compared with foscarnet, nucleoside analogues (HR, 2.72; 95% CI, 1.28-5.75) showed a higher risk of HA-AKI. The associations were consistent across various subgroups and sensitivity analysis. Conclusion Among antiviral therapies for herpes zoster, acyclovir/valacyclovir was associated with the highest relative risk of HA-AKI, and the association appears to be dose dependent. Clinicians should exercise rational drug use according to the different renal toxicity associated with a particular antiviral drug.

Valaciclovir: Its Antiviral Activity, Pharmacokinetic Properties and Therapeutic Efficacy in Herpesvirus Infections: An Review

Valaciclovir, the L-valyl ester of aciclovir (acyclovir), is an oral prodrug that undergoes rapid and extensive first-pass metabolism to yield aciclovir and the essential amino acid L-valine. Aciclovir, the active antiviral component of valaciclovir, shows good in vitro activity against the herpesviruses herpes simplex virus (HSV)-1, HSV-2 and varicella zoster virus. The bio availability of aciclovir from oral valaciclovir is considerably greater than that achieved after oral acyclovir administration. Valaciclovir is an effective treatment for herpes zoster in immunocompetent adults. Valaciclovir was also effective in suppressing recurrent episodes of genital herpes and significantly prolonged the time to a recurrent episode of infection compared with placebo

Effect of Herpes Zoster Treatment and Sudden Sensorineural Hearing Loss Using National Health Insurance Claims Data of South Korea.

Background and objectives: Herpes zoster (HZ) is caused by the reactivation of a pre-existing latent varicella zoster virus, which is one of the viruses that causes hearing loss, and hearing loss may occur due to a systemic immune response even if it does not invade the auditory nerve. This study aimed to determine the correlation between sudden sensorineural hearing loss (SSNHL) in older adult patients who received HZ treatment. Materials and Methods: We used the cohort data of patients aged 60 years and above (n = 624,646) between 2002 and 2015 provided by the National Health Insurance Service. The patients were divided into two groups: those who were diagnosed with HZ between 2003 and 2008 (group H, n = 36,121) and those who had not been diagnosed with HZ between 2002 and 2015 (group C, n = 584,329). Results: In the main model (adjusted HR = 0.890, 95% CI = 0.839-0.944, p < 0.001) adjusted for sex, age, and income, and the full model (adjusted HR = 0.894, 95% CI = 0.843-0.949, p < 0.001) adjusted for all comorbidities, group H had a lower risk of SSNHL than group C. Conclusions: This study showed that patients who received HZ treatment had a lower incidence of SSNHL within five years after diagnosis.