Herpes zoster
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Herpes zoster mjehurići na vratu i ramenu
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ReferencesHerpes zoster, uzrokovan reaktivacijom virusa varicella zoster koji je odgovoran za vodene kozice, pogađa oko milijun ljudi godišnje u Sjedinjenim Državama, s doživotnim rizikom od 30 %. Osobe s oslabljenim imunološkim sustavom znatno su sklonije razvoju šindre, a simptomi obično počinju malaksalošću, glavoboljom i blagom vrućicom, nakon čega slijede neobični osjećaji na koži nekoliko dana prije pojave osipa. Osip, koji se obično pojavljuje na određenom području tijela, napreduje od prozirnih mjehurića do ranica s krastama tijekom tjedan do deset dana. Presudno je započeti liječenje antivirusnim lijekovima (acyclovir, valacyclovir ili famciclovir) unutar 72 sata od pojave osipa. Postherpetička neuralgija, česta komplikacija koja se očituje dugotrajnom boli u zahvaćenom području, pogađa otprilike jednog od pet pacijenata i zahtijeva kontinuirano liječenje lijekovima poput gabapentina, pregabalina ili određenih antidepresiva, uz lokalne pripravke poput lidokaina ili kapsaicina. Cijepljenje protiv virusa varicella zoster preporučuje se odraslim osobama od 50 i više godina kako bi se smanjio rizik od herpesa.
Shingles, caused by the reactivation of the varicella zoster virus responsible for chickenpox, affects around 1 million people annually in the United States, with a lifetime risk of 30%. Those with weakened immune systems are significantly more prone to developing shingles, with symptoms typically starting with malaise, headache, and a mild fever, followed by unusual skin sensations a few days before the appearance of a rash. This rash, usually appearing in a specific area of the body, progresses from clear blisters to crusted sores over a week to ten days. Prompt treatment with antiviral medications (acyclovir, valacyclovir, or famciclovir) within 72 hours of rash onset is crucial. Postherpetic neuralgia, a common complication characterized by prolonged pain in the affected area, affects about one in five patients and requires ongoing management with medications such as gabapentin, pregabalin, or certain antidepressants, along with topical agents like lidocaine or capsaicin. Vaccination against the varicella zoster virus is recommended for adults aged 50 and above to reduce the risk of shingles.
Shingles, caused by the reactivation of the varicella zoster virus responsible for chickenpox, affects around 1 million people annually in the United States, with a lifetime risk of 30%. Those with weakened immune systems are significantly more prone to developing shingles, with symptoms typically starting with malaise, headache, and a mild fever, followed by unusual skin sensations a few days before the appearance of a rash. This rash, usually appearing in a specific area of the body, progresses from clear blisters to crusted sores over a week to ten days. Prompt treatment with antiviral medications (acyclovir, valacyclovir, or famciclovir) within 72 hours of rash onset is crucial. Postherpetic neuralgia, a common complication characterized by prolonged pain in the affected area, affects about one in five patients and requires ongoing management with medications such as gabapentin, pregabalin, or certain antidepressants, along with topical agents like lidocaine or capsaicin. Vaccination against the varicella zoster virus is recommended for adults aged 50 and above to reduce the risk of shingles.
Herpes zoster ima tendenciju da se češće javlja kod osoba starijih od 50 godina, onih s oslabljenim imunološkim sustavom i onih koji uzimaju lijekove za supresiju imuniteta. Uzrokuje ga reaktivacija virusa varicella‑zoster, istog virusa koji uzrokuje vodene kozice. Simptomi poput vrućice, boli i svrbeža obično prethode pojavi karakterističnog osipa. Najčešća komplikacija je postherpetička neuralgija, koja predstavlja stalnu bol u živcima nakon što osip nestane. Čimbenici rizika i komplikacije povezane s herpes zosterom variraju ovisno o dobi, imunološkom stanju i vremenu početka liječenja. Pokazalo se da cijepljenje kod osoba starijih od 60 godina značajno smanjuje pojavu herpes zoster‑a i postherpetičke neuralgije. Početak uzimanja antivirusnih lijekova i analgetika unutar 72 sata od pojave osipa može smanjiti težinu i komplikacije herpes zoster‑a i postherpetičke neuralgije.
Herpes zoster tends to occur more frequently in people aged 50 and older, those with weakened immune systems, and those taking immunosuppressant medications. It's triggered by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox. Symptoms like fever, pain, and itching commonly precede the appearance of the characteristic rash. The most common complication is post-herpetic neuralgia, which is persistent nerve pain after the rash clears up. The risk factors and complications associated with herpes zoster vary depending on age, immune health, and timing of treatment initiation. Vaccination for individuals aged 60 and above has been shown to significantly reduce the occurrence of herpes zoster and post-herpetic neuralgia. Starting antiviral medications and pain relievers within 72 hours of rash onset can lessen the severity and complications of herpes zoster and post-herpetic neuralgia.
Herpes zoster tends to occur more frequently in people aged 50 and older, those with weakened immune systems, and those taking immunosuppressant medications. It's triggered by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox. Symptoms like fever, pain, and itching commonly precede the appearance of the characteristic rash. The most common complication is post-herpetic neuralgia, which is persistent nerve pain after the rash clears up. The risk factors and complications associated with herpes zoster vary depending on age, immune health, and timing of treatment initiation. Vaccination for individuals aged 60 and above has been shown to significantly reduce the occurrence of herpes zoster and post-herpetic neuralgia. Starting antiviral medications and pain relievers within 72 hours of rash onset can lessen the severity and complications of herpes zoster and post-herpetic neuralgia.
Klinička ispitivanja prije odobrenja pokazuju da živo cjepivo protiv zoster‑a djeluje oko 50–70 %, dok rekombinantno cjepivo ima bolje rezultate, u rasponu od 90–97 %. Studije u stvarnom svijetu podupiru nalaze ispitivanja, pokazujući da je živo cjepivo djelotvorno oko 46 %, dok je rekombinantno oko 85 %.
The pre-licensure clinical trials show the efficacy of the live zoster vaccine to be between 50 and 70% and for the recombinant vaccine to be higher at 90 to 97%. Real-world effectiveness studies, with a follow-up of approximately 10 years, were reviewed in this article. These data corroborated the efficacy studies, with vaccine effectiveness being 46% and 85% for the live and recombinant vaccines, respectively.
The pre-licensure clinical trials show the efficacy of the live zoster vaccine to be between 50 and 70% and for the recombinant vaccine to be higher at 90 to 97%. Real-world effectiveness studies, with a follow-up of approximately 10 years, were reviewed in this article. These data corroborated the efficacy studies, with vaccine effectiveness being 46% and 85% for the live and recombinant vaccines, respectively.
Vodene kozice, koje se nazivaju i varičela, rezultat su početne infekcije virusom, koja se najčešće javlja tijekom djetinjstva ili adolescencije. Nakon što se vodene kozice izliječe, virus može ostati neaktivan (uspavan) u živčanim stanicama godinama ili desetljećima, a potom se ponovno aktivirati. Herpes zoster nastaje kada se uspavani virus varičele ponovno aktivira. Virus putuje duž živčanih tijela do kožnih završetaka i stvara mjehuriće. Tijekom izbijanja herpes zoster, izloženost virusu varicella koji se nalazi u mjehurićima može uzrokovati vodene kozice kod osobe koja još nije imala vodene kozice.
Čimbenici rizika za reaktivaciju uspavanog virusa uključuju stariju dob, lošu imunološku funkciju i oboljevanje od vodenih kozica prije 18 mjeseci života. Varicella‑zoster virus nije isto što i herpes simplex virus, iako oba pripadaju obitelji herpesvirusa.
Herpes zoster cjepiva smanjuju rizik od nastanka bolesti za 50 %–90 % i također smanjuju učestalost i težinu postherpetičke neuralgije. Ako se razvije herpes zoster, antivirusni lijekovi, poput acyclovir (aciklovir), mogu ublažiti simptome i skratiti trajanje bolesti pod uvjetom da se započnu unutar 72 sata od pojave osipa.
○ Liječenje
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