What is herpes zoster. Is it transferable disease? How long will it take to get cured?

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Posted on Thu, 19 Jul 2012 in Infections
Question: What is herpis zoster.is this disease spreads. What is the best treatment ?how much time it takes to cure
doctor
Answered by Dr. Anil Grover 3 hours later
Hi,

Thanks for writing in.
I am a medical specialist with an addition degree in Cardiology.
I read your question with diligence and shall try to answer in detail for it appears you want know fairly good amount of details. If I am not clear at any place please do not hesitate in asking as a query, I will get back to you at the soonest.

What is Herpes Zoster? Can it spread?
Herpes zoster (commonly referred to as “shingles”) and postherpetic neuralgia result from reactivation of the varicella-zoster virus acquired during the primary varicella infection, or chickenpox.
Whereas varicella is generally a disease of childhood, herpes zoster and post-herpetic neuralgia become more common with increasing age.
Factors that decrease immune function, such as human immunodeficiency virus infection, chemotherapy, malignancies and chronic corticosteroid use, may also increase the risk of developing herpes zoster.
The skin lesions begin as a maculopapular rash that follows a dermatomal distribution, commonly referred to as a “belt-like pattern.” The maculopapular rash evolves into vesicles with an erythematous base (reddish base). The vesicles (generally fluid filled eruptions) flare, these are generally painful, and their development is often associated with the occurrence of anxiety and flu-like symptoms.

Reactivation of latent varicella-zoster virus from (nervous system in fact spinal cord extension of brain from where nerves arise) dorsal root ganglia is responsible for the classic dermatomal rash and pain that occur with herpes zoster. Burning pain typically precedes the rash by several days and can persist for several months after the rash resolves.

Coming to involvement of nerves called postherpetic neuralgia, a complication of herpes zoster, pain may persist well after resolution of the rash and can be highly debilitating.


Treatment of Herpes Zoster

The treatment of herpes zoster has three major objectives: (1) treatment of the acute viral infection, (2) treatment of the acute pain associated with herpes zoster and (3) prevention of postherpetic neuralgia. Antiviral agents, oral corticosteroids and adjunctive individualized pain-management modalities are used to achieve these objectives.

ANTIVIRAL AGENTS

Antiviral agents have been shown to decrease the duration of herpes zoster rash and the severity of pain associated with the rash.12 However, these benefits have only been demonstrated in patients who received antiviral agents within 72 hours after the onset of rash. Antiviral agents may be beneficial as long as new lesions are actively being formed, but they are unlikely to be helpful after lesions have crusted.

The effectiveness of antiviral agents in preventing postherpetic neuralgia is more controversial. Numerous studies evaluating this issue have been conducted, but the results have been variable.
Acyclovir: Based on the findings of multiple studies, acylovir (Zovirax) therapy appears to produce a moderate reduction in the development of postherpetic neuralgia.13 Other antiviral agents, specifically valacyclovir (Valtrex) and famciclovir (Famvir), appear to be at least as effective as acyclovir.

1. Acyclovir, the prototype anti viral drug may be given orally or intravenously. Major drawbacks of orally administered acyclovir include its lower bioavailability compared with other agents and its dosing frequency (five times daily). Intravenously administered acyclovir is generally used only in patients who are severely immunocompromised or who are unable to take medications orally.

2. Valacyclovir, a prodrug of acyclovir, is administered three times daily. Compared with acyclovir, valacyclovir may be slightly better at decreasing the severity of pain associated with herpes zoster, as well as the duration of postherpetic neuralgia.14 Valacyclovir is also more bioavailable than acyclovir, and oral administration produces blood drug levels comparable to the intravenous administration of acyclovir.

3. Famciclovir is also a DNA polymerase inhibitor. The advantages of famciclovir are its dosing schedule (three times daily), its longer intracellular half-life compared with acyclovir and its better bioavailability compared with acyclovir and valacyclovir.

The choice of which antiviral agent to use is individualized. Dosing schedule and cost may be considerations. All three antiviral agents are generally well tolerated. The most common adverse effects are nausea, headache, vomiting, dizziness and abdominal pain.

Other Supplementary Treatment:
Antiviral drugs are prescription drugs. Your doctor may feel that the addition of an orally administered corticosteroid can provide modest benefits in reducing the pain of herpes zoster and the incidence of postherpetic neuralgia.

Ocular involvement in herpes zoster can lead to rare but serious complications and generally merits referral to an ophthalmologist.

Patients with postherpetic neuralgia may require narcotics for adequate pain control. Tricyclic antidepressants or anticonvulsants, often given in low dosages, may help to control neuropathic pain. Capsaicin, lidocaine patches and nerve blocks can also be used in selected patients.

With Best Wishes.

Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Anil Grover

Cardiologist

Practicing since :1981

Answered : 922 Questions

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