Herpes zoster
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Herpes zoster mehurji na vratu in ramenih
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Pasovec, ki ga povzroča ponovna aktivacija virusa varicella zoster, ki je odgovoren za norice, prizadene približno 1 milijon ljudi letno v Združenih državah, s tveganjem za vse življenje 30 %. Tisti z oslabljenim imunskim sistemom so znatno bolj nagnjeni k razvoju pasovca, pri čemer se simptomi običajno začnejo s slabim počutjem, glavobolom in blago zvišano telesno temperaturo, ki ji sledijo nenavadni občutki na koži nekaj dni pred pojavom izpuščaja. Ta izpuščaj, ki se običajno pojavi na določenem predelu telesa, napreduje od prozornih mehurjev do skorjastih ran v enem tednu do desetih dneh. Hitro zdravljenje s protivirusnimi zdravili (acyclovir, valacyclovir, or famciclovir) v 72 urah po pojavu izpuščaja je ključnega pomena. Postherpetična nevralgija, pogost zaplet, za katerega je značilna dolgotrajna bolečina na prizadetem območju, prizadene približno enega od petih bolnikov in zahteva stalno zdravljenje z zdravili, kot so gabapentin, pregabalin ali nekateri antidepresivi, skupaj z lokalnimi zdravili, kot sta lidokain ali kapsaicin. Cepljenje proti virusu varicella zoster je priporočljivo za odrasle, stare 50 let in več, da se zmanjša tveganje za pasavec.
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 se pogosteje pojavlja pri ljudeh, starih 50 let in več, tistih z oslabljenim imunskim sistemom in tistih, ki jemljejo imunosupresivna zdravila. Sproži ga ponovna aktivacija virusa varicella-zoster, istega virusa, ki povzroča norice. Simptomi, kot so vročina, bolečina in srbenje, se običajno pojavijo pred pojavom značilnega izpuščaja. Najpogostejši zaplet je postherpetična nevralgija, ki je vztrajna živčna bolečina po tem, ko izpuščaj izgine. Dejavniki tveganja in zapleti, povezani s herpesom zoster, se razlikujejo glede na starost, imunsko stanje in čas začetka zdravljenja. Dokazano je, da cepljenje za osebe, stare 60 let in več, znatno zmanjša pojavnost herpesa zostra in postherpetične nevralgije. Začetek jemanja protivirusnih zdravil in sredstev za lajšanje bolečin v 72 urah po pojavu izpuščaja lahko zmanjša resnost in zaplete herpesa zostra in postherpetične nevralgije.
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.
Klinična preskušanja pred odobritvijo kažejo, da živo cepivo proti pasavcu deluje približno 50 do 70 %, medtem ko je rekombinantno cepivo boljše, in sicer od 90 do 97 %. V študijah v resničnem svetu podpirajo izsledke poskusov, ki kažejo, da je živo cepivo približno 46-odstotno učinkovito, medtem ko je rekombinantno približno 85-odstotno.
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.
Norice, imenovane tudi varicella, so posledica začetne okužbe z virusom, ki se običajno pojavi v otroštvu ali adolescenci. Ko so norice ozdravljene, lahko virus ostane neaktiven (mirujoč) v človeških živčnih celicah leta ali desetletja, nato pa se lahko ponovno aktivira. Herpes zoster nastane, ko se mirujoči virus noric ponovno aktivira. Nato virus potuje po živčnih telesih do živčnih končičev v koži, kjer nastanejo mehurji. Med izbruhom herpes zoster lahko izpostavljenost virusu noric v mehurčkih herpes zoster povzroči norice pri osebi, ki noric še ni prebolela.
Dejavniki tveganja za ponovno aktivacijo mirujočega virusa vključujejo starost, slabo delovanje imunskega sistema in prebolele norice pred 18. mesecem starosti. Virus Varicella zoster ni enak virusu herpes simplex, čeprav oba pripadata isti družini herpesvirusov.
Cepiva herpes zoster zmanjšajo tveganje za herpes zoster za 50 % do 90 %. Prav tako zmanjša stopnjo postherpetične nevralgije in, če se pojavi herpes zoster , njeno resnost. Če se razvije herpes zoster , lahko protivirusna zdravila, kot je aciklovir, zmanjšajo resnost in trajanje bolezni, če se začnejo jemati v 72 urah po pojavu izpuščaja.
○ Zdravljenje
Če se lezije hitro širijo, čim prej obiščite zdravnika za protivirusno zdravljenje.
Potrebna so tako protivirusna zdravila kot zdravila za nevralgijo. Moral bi počivati in prenehati piti alkohol.
#Acyclovir
#Fancyclovir
#Valacyclovir
#Gabapentin
#Pregabalin