Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-18T15:00:39.422Z Has data issue: false hasContentIssue false

65 - Antiviral therapy of varicella-zoster virus infections

from Part VI - Antiviral therapy

Published online by Cambridge University Press:  24 December 2009

By
John W. Gnann Jr.
Edited by
Ann Arvin ,
Gabriella Campadelli-Fiume ,
Edward Mocarski ,
Patrick S. Moore ,
Bernard Roizman ,
Richard Whitley  and
Koichi Yamanishi
John W. Gnann Jr.
Affiliation:
Departments of Medicine, Pediatrics and Microbiology, Division of Infectious Diseases, University of Alabama at Birmingham and the Birmingham VA Medical Center Birmingham, AL, USA
Ann Arvin
Affiliation:
Stanford University, California
Gabriella Campadelli-Fiume
Affiliation:
Università degli Studi, Bologna, Italy
Edward Mocarski
Affiliation:
Emory University, Atlanta
Patrick S. Moore
Affiliation:
University of Pittsburgh
Bernard Roizman
Affiliation:
University of Chicago
Richard Whitley
Affiliation:
University of Alabama, Birmingham
Koichi Yamanishi
Affiliation:
University of Osaka, Japan
Get access

Summary

Introduction

Primary infection caused by varicella-zoster virus (VZV) is manifest by varicella (chickenpox), while reactivation of latent virus causes herpes zoster (shingles). In immunocompetent children, varicella is usually not a serious disease, but can cause severe morbidity and mortality in adults and in immunocompromised individuals. Similarly, herpes zoster is associated with much greater morbidity in patients with impaired cell-mediated immune responses. In addition, herpes zoster can cause prolonged pain (postherpetic neuralgia) that can be very difficult to manage, particularly in older individuals. The outcomes of varicella and herpes zoster, especially in immunocompromised patients, have been dramatically improved by the development of safe and effective antiviral drugs with potent activity against VZV. Early drugs with modest efficacy and substantial toxicity (e.g., interferon, vidarabine, etc.) have been replaced by antiviral agents with enhanced in vitro activity, improved pharmacokinetic properties, and excellent safety profiles.

Diagnosis

Most experienced physicians will be able to make an accurate clinical diagnosis of chickenpox based on the distinctive appearance of the skin lesions (Fig. 65.1(a)). The clinical syndrome of a child with mild constitutional symptoms, the typical diffuse vesicular rash, and no prior history of chickenpox is strongly suggestive of the diagnosis, especially if there has been exposure to VZV within the previous two weeks. However, in countries where the incidence of varicella is dramatically declining (such as the United States), younger physicians will have fewer opportunities to see patients with chickenpox and may feel less confident with the clinical diagnosis.

Type
Chapter
Information
Human Herpesviruses
Biology, Therapy, and Immunoprophylaxis
 , pp. 1175 - 1191
Publisher: Cambridge University Press
Print publication year: 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Acosta, E. P. and Balfour, H. H. Jr. (2001). Acyclovir for treatment of postherpetic neuralgia: efficacy and pharmacokinetics. Antimicrob. Agents Chemother., 45, 2771–2774.CrossRefGoogle ScholarPubMed
Acosta, E. P. and Fletcher, C. V. (1997). Valacyclovir. Ann. Pharmacother., 31, 185–191.CrossRefGoogle ScholarPubMed
Arbeter, A. M., Granowetter, L., Starr, S. E.et al. (1990). Immunization of children with acute lymphoblastic leukemia with live attenuated varicella vaccine without complete suspension of chemotherapy. Pediatrics, 85, 338–344.Google ScholarPubMed
Arvin, A. M. (2002). Antiviral therapy for varicella and herpes zoster. Semin. Pediatr. Infect. Dis., 13, 12–21.CrossRefGoogle ScholarPubMed
Asano, Y., Yoshikawa, T., Suga, S.et al. (1993). Postexposure prophylaxis of varicella in family contacts by oral acyclovir. Pediatrics, 92, 219–222.Google Scholar
Balfour, H. H., Bean, B., Laskin, O. L.et al. (1983). Acyclovir halts progression of herpes zoster in immunocompromised patients. N. Engl. J. Med., 308, 1448–1453.CrossRefGoogle ScholarPubMed
Balfour, H. H., Kelly, J. M., Suarez, C. S.et al. (1990). Acyclovir treatment of varicella in otherwise healthy children. J. Pediatr., 116, 633–639.CrossRefGoogle ScholarPubMed
Balfour, H. H. Jr., Rotbart, H. A., Feldman, S.et al. (1992). Acyclovir treatment of varicella in otherwise healthy adolescents. The Collaborative Acyclovir Varicella Study Group. J. Pediatr., 120 (4, Part 1), 627–633.CrossRefGoogle ScholarPubMed
Beutner, K. R., Friedman, D. J., Forszpaniak, C.et al. (1995). Valaciclovir compared with acyclovir for improved therapy for herpes zoster in immunocompetent adults. Antimicrob. Agents Chemother., 39, 1546–1553.CrossRefGoogle ScholarPubMed
Bodsworth, N. J., Boag, F., Burdge, D.et al. (1997). Evaluation of sorivudine (BV-araU) versus acyclovir in the treatment of acute localized herpes zoster in human immunodeficiency virus-infected adults. J. Infect. Dis., 176, 103–111.CrossRefGoogle ScholarPubMed
Boivin, G., Edelman, C. K., Pedneault, L.et al. (1994). Phenotypic and genotypic characterization of acyclovir-resistant varicella zoster viruses isolated from persons with AIDS. J. Infect. Dis., 170, 68–75.CrossRefGoogle ScholarPubMed
Bowsher, D. (2003). Factors influencing the features of postherpetic neuralgia and outcome when treated with tricyclics. Eur. J. Pain, 7, 1–7.CrossRefGoogle ScholarPubMed
Breton, G., Fillet, A. M., Katlama, C.et al. (1998). Acyclovir-resistant herpes zoster in human immunodeficiency virus-infected patients: results of foscarnet therapy. Clin. Infect. Dis., 27, 1525–1527.CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention (1996). Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP). Morb. Mortal. Weekly Rep., 45, 1–36.
Cobo, L. M., Foulks, G. N., Liesgang, T.et al. (1986). Oral acyclovir in the treatment of acute herpes zoster ophthalmicus. Ophthalmology, 93, 763–770.CrossRefGoogle ScholarPubMed
Colin, J., Prisant, O., Cochener, B.et al. (2000). Comparison of the efficacy and safety of valaciclovir and acyclovir for the treatment of herpes zoster ophthalmicus. Ophthalmology, 107, 1507–1511.CrossRefGoogle ScholarPubMed
Dahl, H., Marcoccia, J., and Linde, A. (1997). Antigen detection: the method of choice in comparison with virus isolation and serology for laboratory diagnosis of herpes zoster in human immunodeficiency virus-infected patient. J. Clin. Microbiol., 35, 345–349.Google Scholar
Davies, P. S. and Galer, B. S. (2004). Review of lidocaine patch 5% studies in the treatment of postherpetic neuralgia. Drugs, 64, 937–947.CrossRefGoogle ScholarPubMed
Blanchardiere, A., Rozenberg, F., Caumes, E.et al. (2000). Neurological complications of varicella-zoster virus infection in adults with human immunodeficiency virus infection. Scand. J. Infect. Dis., 32, 263–269.Google Scholar
Degreef, H. and the Famciclovir Herpes Zoster Study Group (1994). Famciclovir, a new oral antiherpes drug: results of the first controlled clinical study demonstrating its efficacy and safety in the treatment of uncomplicated herpes zoster in immunocompetent patient. Int. J. Antimicrob. Agents, 4, 241–246.CrossRefGoogle Scholar
Dodd, D. A., Burger, J., Edwards, K. M.et al. (2001). Varicella in a pediatric heart transplant population on nonsteroid maintenance immunosuppression. Pediatrics, 108, E80.CrossRefGoogle Scholar
Dunkle, L. M., Arvin, A. M., Whitley, R. J.et al. (1991). A controlled trial of acyclovir for chickenpox in normal children. N. Engl. J. Med., 325, 1539–1544.CrossRefGoogle ScholarPubMed
Dworkin, R. H. and Schmader, K. E. (2003). Treatment and prevention of postherpetic neuralgia. Clin. Infect. Dis., 36, 877–882.CrossRefGoogle ScholarPubMed
Dworkin, R. H., Boon, R. J., Griffin, D. R.et al. (1998). Postherpetic neuralgia: impact of famciclovir, age, rash severity, and acute pain in herpes zoster patients. J. Infect. Dis., 178 (Suppl. 1), S76–S80.CrossRefGoogle ScholarPubMed
Dworkin, R. H., Perkins, F. M., and Nagasako, E. M. (2000). Prospects for the prevention of postherpetic neuralgia in herpes zoster patients. Clin. J. Pain, 16 (Suppl. 2), S90–100.CrossRefGoogle ScholarPubMed
Dworkin, R. H., Corbin, A. E., Young, J. P. Jr.et al. (2003). Pregabalin for the treatment of postherpetic neuralgia: a randomized, placebo-controlled trial. Neurology, 60, 1274–1283.CrossRefGoogle ScholarPubMed
Furth, S. L. and Fivush, B. A. (2002). Varicella vaccination in pediatric kidney transplant candidates. Pediatr. Transpl., 6, 97–100.CrossRefGoogle ScholarPubMed
Galindez, O. A., Sabates, N. R., Whitacre, M. W.et al. (1996). Rapidly progressive outer retinal necrosis caused by varicella zoster virus in a patient infected with human immunodeficiency virus. Clin. Infect. Dis., 22, 149–151.CrossRefGoogle Scholar
Gershon, A. A., Mervish, N., LaRussa, P.et al. (1997). Varicella-zoster virus infection in children with underlying human immunodeficiency virus infection. J. Infect. Dis., 176, 1496–1500.CrossRefGoogle ScholarPubMed
Glantz, J. C. and Mushlin, A. I. (1998). Cost-effectiveness of routine antenatal varicella screening. Obstet. Gynecol., 91, 519–528.Google ScholarPubMed
Gnann, J. W. Jr. (2002). Varicella-zoster virus: atypical presentations and unusual complications. J. Infect. Dis., 186 (Suppl. 1), S91–S98.CrossRefGoogle ScholarPubMed
Gnann, J. W. Jr. and Whitley, R. J. (2002). Clinical practice. Herpes zoster. N. Engl. J. Med., 347, 340–346.CrossRefGoogle ScholarPubMed
Gnann, J. W., Crumpacker, C. S., Lalezari, J. P.et al. (1998). Sorivudine versus acyclovir for treatment of dermatomal herpes zoster in human immunodeficiency virus-infected patients: results from a randomized, controlled clinical trial. Antimicrob. Agents Chemother., 42, 1139–1145.Google ScholarPubMed
Gross, G., Schofer, H., Wassilew, S.et al. (2003). Herpes zoster guideline of the German Dermatology Society (DDG). J. Clin. Virol., 26, 277–289; discussion 291–293.CrossRefGoogle Scholar
Haake, D. A., Zakowski, P. C., Haake, D. L.et al. (1990). Early treatment with acyclovir for varicella pneumonia in otherwise healthy adults: retrospective controlled study and review. Rev. Infect. Dis., 12, 788–798.CrossRefGoogle ScholarPubMed
Harding, S. P. and Porter, S. M. (1991). Oral acyclovir in herpes zoster ophthalmicus. Curr. Eye Res., 10 (Suppl.), 177–182.CrossRefGoogle ScholarPubMed
Harger, J. H., Ernest, J. M., Thurnau, G. R.et al. (2002). Frequency of congenital varicella syndrome in a prospective cohort of 347 pregnant women. Obstet. Gynecol., 100, 260–265.Google Scholar
Harrison, R. A., Soong, S., Weiss, H. L.et al. (1999). A mixed model for factors predictive of pain in AIDS patients with herpes zoster. J. Pain Symptom Managem., 17, 410–417.CrossRefGoogle ScholarPubMed
Hata, A., Asanuma, H., Rinki, M.et al. (2002). Use of an inactivated varicella vaccine in recipients of hematopoietic-cell transplants. N. Engl. J. Med., 347, 26–34.CrossRefGoogle ScholarPubMed
Hellden, A., Odar-Cederlof, I., Diener, P.et al. (2003). High serum concentrations of the acyclovir main metabolite 9-carboxymethoxymethylguanine in renal failure patients with acyclovir-related neuropsychiatric side effects: an observational study. Nephrol. Dial. Transpl., 18, 1135–1141.CrossRefGoogle ScholarPubMed
Herbort, C. P., Buechi, E. R., Piguet, B.et al. (1991). High dose oral acyclovir in acute herpes zoster ophthalmicus: the end of the corticosteroid era. Curr. Eye Res., 10 (Suppl.), 171–175.CrossRefGoogle ScholarPubMed
Hoang-Xuan, T., Buchi, E. R., Herbot, C. P.et al. (1992). Oral acyclovir for herpes zoster ophthalmicus. Ophthalmology, 99, 1062–1071.CrossRefGoogle ScholarPubMed
Huff, J. C., Bean, B., Balfour, H. H.et al. (1988). Therapy of herpes zoster with oral acyclovir. Am. J. Med., 85 (Suppl. 2A), 84–88.Google ScholarPubMed
Jacobson, M. A., Berger, T. G., Fikrig, S.et al. (1990). Acyclovir-resistant varicella zoster virus infection after chronic oral acyclovir therapy in patients with the acquired immunodeficiency syndrome (AIDS). Ann. Intern. Med., 112, 187–191.CrossRefGoogle Scholar
Johnson, R. W. (2002). Consequences and management of pain in herpes zoster. J. Infect. Dis., 186 (Suppl. 1), S83–S90.CrossRefGoogle ScholarPubMed
Johnson, R. W. and Dworkin, R. H. (2003). Treatment of herpes zoster and postherpetic neuralgia. Br. Med. J., 326, 748–750.CrossRefGoogle ScholarPubMed
Keam, S. J., Chapman, T. M., and Figgitt, D. P. (2004). Brivudin (bromovinyl deoxyuridine). Drugs, 64, 2091–2097.CrossRefGoogle Scholar
Kotani, N., Kushikata, T., Hashimoto, H.et al. (2000). Intrathecal methylprednisolone for intractable postherpetic neuralgia. N. Engl. J. Med., 343, 1514–1519.CrossRefGoogle ScholarPubMed
Levin, M. J., Dahl, K. M., Weinberg, A.et al. (2003a). Development of resistance to acyclovir during chronic infection with the Oka vaccine strain of varicella-zoster virus, in an immunosuppressed child. J. Infect. Dis., 188, 954–959.CrossRefGoogle Scholar
Levin, M. J., Smith, J. G., Kaufhold, R. M.et al. (2003b). Decline in varicella-zoster virus (VZV)-specific cell-mediated immunity with increasing age and boosting with a high-hose VZV vaccine. J. Infect. Dis., 188, 1336–1344.CrossRefGoogle Scholar
Liesegang, T. J. (1999). Varicella zoster viral disease. Mayo Clin. Proc., 74, 983–998.CrossRefGoogle ScholarPubMed
Lionnet, F., Pulik, M., Genet, P.et al. (1996). Myelitis due to varicella-zoster virus in 2 patients with AIDS: successful treatment with acyclovir. Clin. Infect. Dis., 22, 138–140.CrossRefGoogle ScholarPubMed
Ljungman, P. (2001). Prophylaxis against herpesvirus infections in transplant recipients. Drugs, 61, 187–196.CrossRefGoogle ScholarPubMed
Ljungman, P., Lonnqvist, B., Ringden, O.et al. (1989). A randomized trial of oral versus intravenous acyclovir for treatment of herpes zoster in bone marrow transplant recipients. Bone Marrow Transpl., 4, 613–615.Google ScholarPubMed
Lundgren, G., Wilecek, H., Lönnqvist, B.et al. (1985). Acyclovir prophylaxis in bone marrow transplant recipients. Scand. J. Infect. Dis., 47 (Suppl. 7), 137–144.Google ScholarPubMed
McKendrick, M. W., McGill, J. I., White, J. E.et al. (1986). Oral acyclovir in acute herpes zoster. Br. Med. J., 293, 1529–1532.CrossRefGoogle Scholar
Meyers, J. D., Wade, J. C., Shepp, D. H.et al. (1984). Acyclovir treatment of varicella-zoster virus infection in the compromised host. Transplantation, 37, 571–574.CrossRefGoogle ScholarPubMed
Morton, P. and Thomson, A. N. (1989). Oral acyclovir in the treatment of herpes zoster in general practice. N Z Med. J., 102, 93–95.Google ScholarPubMed
Nagasako, E. M., Johnson, R. W., Griffin, D. R.et al. (2002). Rash severity in herpes zoster: correlates and relationship to postherpetic neuralgia. J. Am. Acad. Dermatol., 46, 834–839.CrossRefGoogle ScholarPubMed
Nathwani, D., Maclean, A., Conway, S.et al. (1998). Varicella infections in pregnancy and the newborn. A review prepared for the UK Advisory Group on Chickenpox on behalf of the British Society for the Study of Infection. J. Infect., 36 (Suppl. 1), 59–71.CrossRefGoogle Scholar
Nyerges, G., Meszner, Z., Gyarmati, E.et al. (1988). Acyclovir prevents dissemination of varicella in immunocompromised children. J. Infect. Dis., 157, 309–313.CrossRefGoogle ScholarPubMed
Opstelten, W., Wijck, A. J., and Stolker, R. J. (2004). Interventions to prevent postherpetic neuralgia: cutaneous and percutaneous techniques. Pain, 107, 202–206.CrossRefGoogle ScholarPubMed
Ormerod, L. D., Larkin, J. A., Margo, C. A.et al. (1998). Rapidly progressive herpetic retinal necrosis: a blinding disease characteristic of advanced AIDS. Clin. Infect. Dis., 26, 34–45.CrossRefGoogle ScholarPubMed
Oxman, M. N.et al. (2005). A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N. Engl. J. Med., 352, 2271–2284.CrossRefGoogle ScholarPubMed
Palay, D. A., Sternberg, P. Jr., Davis, J.et al. (1991). Decrease in the risk of bilateral acute retinal necrosis by acyclovir therapy. Am. J. Ophthalmol., 112, 250–255.CrossRefGoogle ScholarPubMed
Perren, T. J., Powles, R. L., Easton, D.et al. (1988). Prevention of herpes zoster in patients by long-term oral acyclovir after allogenic bone marrow transplantation. Am. J. Med., 85 (Suppl. 2A), 99–101.Google Scholar
Perry, C. M. and Wagstaff, A. J. (1995). Famciclovir: a review of its pharmacological properties and therapeutic efficacy in herpesvirus infections. Drugs, 50, 396–415.CrossRefGoogle ScholarPubMed
Poscher, M. E. (1994). Successful treatment of varicella-zoster virus meningoencephalitis in patients with AIDS: report of 4 cases and review. AIDS, 8, 1115–1117.CrossRefGoogle Scholar
Prober, C. G., Kirk, L. E., and Keeney, R. E. (1982). Acyclovir therapy of chickenpox in immunocompromised children: a collaborative study. J. Pediatr., 101, 622–625.CrossRefGoogle Scholar
Raja, S. N., Haythornthwaite, J. A., Pappagallo, M.et al. (2002). Opioids versus antidepressants in postherpetic neuralgia: a randomized, placebo-controlled trial. Neurology, 59, 1015–1021.CrossRefGoogle ScholarPubMed
Reiff-Eldridge, R., Heffner, C. R., Ephross, S. A.et al. (2000). Monitoring pregnancy outcomes after prenatal drug exposure through prospective pregnancy registries: a pharmaceutical company commitment. Am. J. Obstet. Gynecol., 182, 159–163.CrossRefGoogle ScholarPubMed
Rice, A. S. and Maton, S. (2001). Gabapentin in postherpetic neuralgia: a randomized, double blind, placebo controlled study. Pain, 94, 215–224.CrossRefGoogle Scholar
Rowbotham, M., Harden, N., Stacey, B.et al. (1998). Gabapentin for the treatment of postherpetic neuralgia: a randomized controlled trial. J. Am. Med. Assoc., 280, 1837–1842.CrossRefGoogle ScholarPubMed
Sabatowski, R., Galvez, R., Cherry, D. A.et al. (2004). Pregabalin reduces pain and improves sleep and mood disturbances in patients with post-herpetic neuralgia: results of a randomised, placebo-controlled clinical trial. Pain, 109, 26–35.CrossRefGoogle ScholarPubMed
Schmader, K. (2001). Herpes zoster in older adults. Clin. Infect. Dis., 32, 1481–1486.Google ScholarPubMed
Serota, F. T., Starr, S. E., Bryan, C. K.et al. (1982). Acyclovir treatment of herpes zoster infections: use in children undergoing bone marrow transplantation. J. Am. Med. Assoc., 247, 2132–2135.CrossRefGoogle ScholarPubMed
Severson, E. A., Baratz, K. H., Hodge, D. O.et al. (2003). Herpes zoster ophthalmicus in Olmsted County, Minnesota: have systemic antivirals made a difference?Arch. Ophthalmol., 121, 386–390.CrossRefGoogle ScholarPubMed
Shafran, S. D., Tyring, S. K., Ashton, R.et al. (2004). Once, twice, or three times daily famciclovir compared with aciclovir for the oral treatment of herpes zoster in immunocompetent adults: a randomized, multicenter, double-blind clinical trial. J. Clin. Virol., 29, 248–253.CrossRefGoogle ScholarPubMed
Shepp, D. H., Dandliker, P. S., and Meyers, J. D. (1986). Treatment of varicella-zoster infection in severely immunocompromised patients: a randomized comparison of acyclovir and vidarabine. N. Engl. J. Med., 314, 208–212.CrossRefGoogle ScholarPubMed
Stacey, B. R. and Glanzman, R. L. (2003). Use of gabapentin for postherpetic neuralgia: results of two randomized, placebo-controlled studies. Clin. Ther., 25, 2597–2608.CrossRefGoogle ScholarPubMed
Stranska, R., Schuurman, R., Vos, M.et al. (2004). Routine use of a highly automated and internally controlled real-time PCR assay for the diagnosis of herpes simplex and varicella-zoster virus infections. J. Clin. Virol., 30, 39–44.CrossRefGoogle Scholar
Suga, S., Yoshikawa, T., Ozaki, T.et al. (1993). Effect of oral acyclovir against primary and secondary viraemia in incubation period of varicella. Arch. Dis. Child., 69, 639–642.CrossRefGoogle ScholarPubMed
Tyring, S., Barbarash, R. A., Nahlik, J. E.et al. (1995). Famciclovir for the treatment of acute herpes zoster: effects on acute disease and post-herpetic neuralgia: a randomized, double-blind, placebo-controlled trial. Ann. Int. Med., 123, 89–96.CrossRefGoogle ScholarPubMed
Tyring, S. K., Beutner, K. R., Tucker, B. A.et al. (2000). Antiviral therapy for herpes zoster: randomized, controlled clinical trial of valacyclovir and famciclovir therapy in immunocompetent patients 50 years and older. Arch. Fam. Med., 9, 863–869.CrossRefGoogle ScholarPubMed
Tyring, S., Belanger, R., Bezwoda, W.et al. (2001a). A randomized, double-blind trial of famciclovir versus acyclovir for the treatment of localized dermatomal herpes zoster in immunocompromised patients. Cancer Invest., 19, 13–22.CrossRefGoogle Scholar
Tyring, S., Engst, R., Corriveau, C.et al. (2001b). Famciclovir for ophthalmic zoster: a randomised aciclovir controlled study. Br. J. Ophthalmol., 85, 576–581.CrossRefGoogle Scholar
Tyring, S. K., Baker, D., and Snowden, W. (2002). Valacyclovir for herpes simplex virus infection: long-term safety and sustained efficacy after 20 years' experience with acyclovir. J. Infect. Dis., 186 (Suppl. 1), S40–S46.CrossRefGoogle ScholarPubMed
Wagstaff, A. J. and Bryson, H. M. (1994). Foscarnet: a reappraisal of its antiviral activity, pharmacokinetic properties and therapeutic use in immunocompromised patients with viral infections. Drugs, 48, 199–226.CrossRefGoogle ScholarPubMed
Wallace, M. R., Bowler, W. A., and Murray, N. B. (1992). Treatment of adult varicella with oral acyclovir. Ann. Intern. Med., 117, 358–363.CrossRefGoogle ScholarPubMed
Wassilew, S. W. and Wutzler, P. (2003a). Oral brivudin in comparison with acyclovir for improved therapy of herpes zoster in immunocompetent patients: results of a randomized, double-blind, multicentered study. Antiviral Res., 59, 49–56.CrossRefGoogle Scholar
Wassilew, S. W. and Wutzler, P. (2003b). Oral brivudin in comparison with acyclovir for herpes zoster: a survey study on postherpetic neuralgia. Antiviral Res., 59, 57–60.CrossRefGoogle Scholar
Watson, B., Seward, J., Yang, A.et al. (2000). Postexposure effectiveness of varicella vaccine. Pediatrics, 105, 84–88.CrossRefGoogle ScholarPubMed
Watson, C. P. and Babul, N. (1998). Efficacy of oxycodone in neuropathic pain: a randomized trial in postherpetic neuralgia. Neurology, 50, 1837–1841.CrossRefGoogle ScholarPubMed
Watson, C. P., Vernich, L., Chipman, M.et al. (1998). Nortriptyline versus amitriptyline in postherpetic neuralgia: a randomized trial. Neurology, 51, 1166–1171.CrossRefGoogle ScholarPubMed
Whitley, R. J. and Gnann, J. W. (1992). Acyclovir: a decade later. N. Engl. J. Med., 327, 782–789.Google ScholarPubMed
Whitley, R. J., Gnann, J. W., Hinthorn, D.et al. (1992). Disseminated herpes zoster in the immunocompromised host: a comparative trial of acyclovir and vidarabine. J. Infect. Dis., 165, 450–455.CrossRefGoogle ScholarPubMed
Whitley, R. J., Weiss, H., Gnann, J. W.et al. (1996). Acyclovir with and without prednisone for the treatment of herpes zoster. A randomized, placebo-controlled trial. The National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group. Ann. Intern. Med., 125, 376–383.CrossRefGoogle ScholarPubMed
Whitley, R. J., Weiss, H. L., Soong, S. J.et al. (1999). Herpes zoster: risk categories for persistent pain. J. Infect. Dis., 179, 9–15.CrossRefGoogle ScholarPubMed
Wilkins, E. G., Leen, C. L., McKendrick, M. W.et al. (1998). Management of chickenpox in the adult. A review prepared for the UK Advisory Group on Chickenpox on behalf of the British Society for the Study of Infection. J. Infect., 36 (Suppl. 1), 49–58.CrossRefGoogle Scholar
Wood, M. J., Ogan, P. H., McKendrick, M. W.et al. (1988). Efficacy of oral acyclovir treatment of acute herpes zoster. Am. J. Med., 85 (Suppl. 2A), 79–83.Google ScholarPubMed
Wood, M. J., Johnson, R. W., McKendrick, M. W.et al. (1994). A randomized trial of acyclovir for 7 days or 21 days with and without prednisolone for treatment of acute herpes zoster. N. Engl. J. Med., 330, 896–900.CrossRefGoogle ScholarPubMed
Wood, M. J., Kay, R., Dworkin, R. H.et al. (1996). Oral acyclovir therapy accelerates pain resolution in patients with herpes zoster: a meta-analysis of placebo-controlled trials. Clin. Infect. Dis., 22, 341–347.CrossRefGoogle ScholarPubMed
Wood, M. J., Shukla, S., Fiddian, A. P.et al. (1998). Treatment of acute herpes zoster: effect of early (<48 h) versus late (48–72 h) therapy with acyclovir and valaciclovir on prolonged pain. J. Infect. Dis., 178 (Suppl. 1), S81–S84.CrossRefGoogle ScholarPubMed
Zaal, M. J., Volker-Dieben, H. J., and D'Amaro, J. (2003). Visual prognosis in immunocompetent patients with herpes zoster ophthalmicus. Acta Ophthalmol. Scand., 81, 216–220.CrossRefGoogle ScholarPubMed
Zaia, J. A., Levin, M. J., Preblud, S. R.et al. (1983). Evaluation of varicella-zoster immune globulin: protection of immunosuppressed children after household exposure to varicella. J. Infect. Dis., 147, 737–743.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×