Biomaterial Database

Varicella zoster virus infections in immunocompromised hosts. A review of the natural history and management. 1988

H H Balfour

Department of Laboratory Medicine and Pathology, University of Minnesota Health Sciences Center, Minneapolis 55455.

Varicella is relatively mild in otherwise normal children, in whom new lesions form for a mean of four days after onset and heal 50 percent of their lesions in eight days. New lesions form in most immunocompromised children for longer than five days and those not treated with antiviral drugs have a 28 percent incidence of pneumonitis and a 7 percent mortality rate. Untreated immunocompromised adults with herpes zoster shed virus for longer (7.0 days) than otherwise normal adults (5.3 days). Herpes zoster is much more likely to disseminate cutaneously in immunocompromised than in immunocompetent hosts. Visceral dissemination, which is a rare event in immunocompetent patients, occurred in 8 percent of prospectively followed untreated immunocompromised hosts with herpes zoster. Acyclovir has been found to be superior to vidarabine for treatment of both chickenpox and herpes zoster. Whether or not steroids should be used to treat herpes zoster remains controversial. Concerns about the use of intravenous acyclovir include the side effects of renal and central nervous system dysfunction and the possibility of emergence of resistant viral strains. None of these concerns has proved to be an impediment to successful treatment of immunocompromised patients. The major future challenge is to find an optimal way to treat varicella zoster virus infections with oral formulations of acyclovir or its congeners.

UI	MeSH Term	Description	Entries
D007108	Immune Tolerance	The specific failure of a normally responsive individual to make an immune response to a known antigen. It results from previous contact with the antigen by an immunologically immature individual (fetus or neonate) or by an adult exposed to extreme high-dose or low-dose antigen, or by exposure to radiation, antimetabolites, antilymphocytic serum, etc.	Immunosuppression (Physiology),Immunosuppressions (Physiology),Tolerance, Immune
D002644	Chickenpox	A highly contagious infectious disease caused by the varicella-zoster virus (HERPESVIRUS 3, HUMAN). It usually affects children, is spread by direct contact or respiratory route via droplet nuclei, and is characterized by the appearance on the skin and mucous membranes of successive crops of typical pruritic vesicular lesions that are easily broken and become scabbed. Chickenpox is relatively benign in children, but may be complicated by pneumonia and encephalitis in adults. (From Dorland, 27th ed)	Varicella,Chicken Pox
D004739	England	A part of Great Britain within the United Kingdom.
D006562	Herpes Zoster	An acute infectious, usually self-limited, disease believed to represent activation of latent varicella-zoster virus (HERPESVIRUS 3, HUMAN) in those who have been rendered partially immune after a previous attack of CHICKENPOX. It involves the SENSORY GANGLIA and their areas of innervation and is characterized by severe neuralgic pain along the distribution of the affected nerve and crops of clustered vesicles over the area. (From Dorland, 27th ed)	Shingles,Zona,Zoster
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000212	Acyclovir	A GUANOSINE analog that acts as an antimetabolite. Viruses are especially susceptible. Used especially against herpes.	Acycloguanosine,9-((2-Hydroxyethoxy)methyl)guanine,Aci-Sanorania,Acic,Aciclobeta,Aciclostad,Aciclovir,Aciclovir Alonga,Aciclovir-Sanorania,Acifur,Acipen Solutab,Acivir,Activir,Acyclo-V,Acyclovir Sodium,Antiherpes Creme,Avirax,Cicloferon,Clonorax,Cusiviral,Genvir,Herpetad,Herpofug,Herpotern,Herpoviric,Isavir,Laciken,Mapox,Maynar,Milavir,Opthavir,Supraviran,Viclovir,Vipral,Virax-Puren,Virherpes,Virmen,Virolex,Virupos,Virzin,Wellcome-248U,Zoliparin,Zovirax,Zyclir,aciclovir von ct,Aci Sanorania,Aciclovir Sanorania,Acyclo V,Alonga, Aciclovir,Sodium, Acyclovir,Solutab, Acipen,Virax Puren,ViraxPuren,Wellcome 248U,Wellcome248U
D014740	Vidarabine	A nucleoside antibiotic isolated from Streptomyces antibioticus. It has some antineoplastic properties and has broad spectrum activity against DNA viruses in cell cultures and significant antiviral activity against infections caused by a variety of viruses such as the herpes viruses, the VACCINIA VIRUS and varicella zoster virus.	Adenine Arabinoside,Ara-A,Arabinofuranosyladenine,Arabinosyladenine,9-beta-Arabinofuranosyladenine,9-beta-D-Arabinofuranosyladenine,Ara A,Vira-A,alpha-Ara A,alpha-D-Arabinofuranosyladenine,beta-Ara A,9 beta Arabinofuranosyladenine,9 beta D Arabinofuranosyladenine,Arabinoside, Adenine,Vira A,ViraA,alpha Ara A,alpha D Arabinofuranosyladenine,beta Ara A
D049670	History, 17th Century	Time period from 1601 through 1700 of the common era.	17th Century History,17th Cent. History (Medicine),17th Cent. History of Medicine,17th Cent. Medicine,Historical Events, 17th Century,History of Medicine, 17th Cent.,History, Seventeenth Century,Medical History, 17th Cent.,Medicine, 17th Cent.,17th Cent. Histories (Medicine),17th Century Histories,Cent. Histories, 17th (Medicine),Century Histories, Seventeenth,Century History, 17th,Century History, Seventeenth,Histories, 17th Cent. (Medicine),Histories, 17th Century,Histories, Seventeenth Century,History, 17th Cent. (Medicine),Seventeenth Century Histories,Seventeenth Century History
D049671	History, 18th Century	Time period from 1701 through 1800 of the common era.	18th Century History,18th Cent. History (Medicine),18th Cent. History of Medicine,18th Cent. Medicine,Historical Events, 18th Century,History of Medicine, 18th Cent.,History, Eighteenth Century,Medical History, 18th Cent.,Medicine, 18th Cent.,18th Century Histories,Cent. History, 18th (Medicine),Cent. Medicine, 18th,Century Histories, 18th,Century Histories, Eighteenth,Century History, 18th,Century History, Eighteenth,Eighteenth Century Histories,Eighteenth Century History,Histories, 18th Century,Histories, Eighteenth Century,History, 18th Cent. (Medicine)
D049672	History, 19th Century	Time period from 1801 through 1900 of the common era.	19th Century History,19th Cent. History (Medicine),19th Cent. History of Medicine,19th Cent. Medicine,Historical Events, 19th Century,History of Medicine, 19th Cent.,History, Nineteenth Century,Medical History, 19th Cent.,Medicine, 19th Cent.,19th Cent. Histories (Medicine),19th Century Histories,Cent. Histories, 19th (Medicine),Cent. History, 19th (Medicine),Century Histories, 19th,Century Histories, Nineteenth,Century History, 19th,Century History, Nineteenth,Histories, 19th Cent. (Medicine),Histories, 19th Century,Histories, Nineteenth Century,History, 19th Cent. (Medicine),Nineteenth Century Histories,Nineteenth Century History