scholarly journals Effectiveness of Live Zoster Vaccine in Preventing Herpes Zoster Ophthalmicus (HZO)

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S413-S413 ◽  
Author(s):  
Laurie Aukes ◽  
Joan Bartlett ◽  
Bruce Fireman ◽  
John Hansen ◽  
Edwin Lewis ◽  
...  
Keyword(s):  
Herpes Zoster ◽  
Cox Regression ◽  
Age Groups ◽  
Weighted Average ◽  
Care Seeking ◽  
Zoster Vaccine ◽  
Herpes Zoster Ophthalmicus ◽  
Varicella Zoster ◽  
Grant Recipient ◽  
Restricted Stock

Abstract Background Herpes zoster ophthalmicus (HZO), caused by reactivation of varicella-zoster virus in or around the eye, can be severe and often results in care-seeking that may be less discretionary than for uncomplicated herpes zoster (HZ). We compared the vaccine effectiveness (VE) of live zoster vaccine against HZO with the VE against HZ overall. Methods Kaiser Permanente Northern California (KPNC) members enter the ongoing cohort study when age-eligible for zoster vaccine starting in 2007. Incident HZ was defined as a new diagnosis of HZ with an antiviral prescription or a positive varicella viral test. Among those, an HZO case was defined as having an HZO diagnosis during an ophthalmology visit within 30 days of the initial HZ diagnosis. VE by age at vaccination and time since vaccination was estimated using Cox regression adjusted for age, race, sex and time-varying measures of healthcare use, comorbidities and immunocompromise status. Average VE over the first 5 years following vaccination was calculated as a weighted average of annual VE estimates. Results During 2007–2014, ~1.3 million individuals ≥50 years of age entered the study population and 29% were vaccinated. Among 48,889 incident HZ cases, 2,858 (6%) had HZO, 87% of whom were unvaccinated. For all ages combined, VE against HZO was 72% (95% CI, 64%-79%) in year 1, similar to 68% (95% CI, 65%-70%) against HZ. VE fell in years 2, 3, 4, and 5 to 47%, 45%, 42% and 27% for HZO and to 47%, 39%, 41% and 37% for HZ. For age groups 60 – 69 and 70 – 79, where we have the most data, initial VE and waning were similar for HZO and HZ. Numbers of HZO cases for 50–59 year olds were too small to evaluate at this time. Average VE against HZO over the first 5 years following vaccination was 52% (95% CI, 42%–60%) for ages 60–69, 51% (95% CI, 39%–61%) for ages 70-79, and 39% (95% CI, 14%-57%) for ages 80+; similarly, 5-year average VE against HZ was 49%, 46%, and 44% for these 3 age groups. Conclusion VE against HZO was similar to VE against HZ regardless of age at vaccination or time since vaccination. Effectiveness of live zoster vaccine in preventing HZO was highest in year one with subsequent waning. Disclosures E. Earley, Merck & Co.: Research Contractor, Salary; M. Marks, Merck and Co. Inc.: Employee, Restricted Stock and Salary; P. Saddier, Merck & Co., Inc.: Employee, Salary; N. P. Klein, GSK: Investigator, Grant recipient; sanofi pasteur: Investigator, Grant recipient; Merck & Co.: Investigator, Grant recipient; MedImmune: Investigator, Grant recipient; Protein Science: Investigator, Grant recipient Pfizer: Investigator, Grant recipient

scholarly journals Human Vaccines and Herpes Zoster Ophthalmicus: Clinical Manifestation, Treatment, and Prevention

2020 ◽  
Vol 8 (F) ◽  
pp. 203-207
Author(s):  
Vina Yuwanda
Keyword(s):  
Herpes Zoster ◽  
Immunosuppressive Agents ◽  
Antibody Detection ◽  
Zoster Vaccine ◽  
Herpes Zoster Ophthalmicus ◽  
Varicella Zoster ◽  
Ocular Manifestations ◽  
Treatment And Prevention ◽  
Control And Prevention ◽  
Recombinant Zoster Vaccine

Herpes zoster ophthalmicus (HZO) is a reactivation of HZ virus that is latent in ophthalmic division of trigeminal ganglion. Patients over 50 years old, premature infant, pregnancy woman, receiving immunosuppressive agents, and malignancies are at risk of having HZO. Ocular manifestations of HZ are ectropion, entropion, ectopic eyelash, keratitis, conjunctivitis, symblepharon, hypoesthesia, episcleritis, scleritis, scleral atrophy and thinning, uveitis, iris atrophy, posterior synechiae, acute retinal necrosis, progressive outer retinal necrosis, retinal detachment, retina atrophy, optic neuritis, optic atrophy, and strabismus. Polymerase chain reaction, antigen detection, and antibody detection can help to confirm diagnosis. Pharmacology treatments for HZ ophthalmicus are antiviral drugs, corticosteroids, analgesics, tricyclic antidepressants, and antiepileptic drug. Non-pharmacology therapies are scleral contact lens, phototherapeutic keratectomy, photorefractive keratectomy, and penetrating keratoplasty. There are two kinds of vaccination which can be given to patients: Live-attenuated varicella zoster vaccine and recombinant zoster vaccine. It is recommended by Centers for Disease Control and Prevention and Food and Drugs Administration to use recombinant zoster vaccine by 50 years old.

scholarly journals An analytical study on clinical patterns of herpes zoster in this era

2019 ◽  
Vol 5 (3) ◽  
pp. 641
Author(s):  
Ravichandran Velappan ◽  
Sindhuja Ramasamy ◽  
Kamalanathan Nallu ◽  
Arulraja Ganapathi
Keyword(s):  
Herpes Zoster ◽  
Age Groups ◽  
Cell Mediated Immunity ◽  
Age Group ◽  
Post Herpetic Neuralgia ◽  
Herpes Zoster Ophthalmicus ◽  
College Hospital ◽  
Varicella Zoster ◽  
Medical College ◽  
History Of

<p class="abstract"><strong>Background:</strong> Herpes zoster is a major health burden in all age groups. It is caused by reactivation of varicella zoster virus from dormant form. The immunity that plays a role in this reactivation is cell mediated immunity. Prodromal features like Fever, pain and itch are common before the onset of zoster rash. The most common complication associated with this disease is post-herpetic neuralgia. Complications associated with herpes zoster depend on the age, immune status, and the time of initializing treatment. Treatment with antiviral drugs within 72 hours of onset of rash onset has been shown to reduce severity and complications associated with zoster and the post-herpetic neuralgia.</p><p class="abstract"><strong>Methods:</strong> We analysed 120 cases of herpes zoster patients who attended Dermatology OPD, in Chengalpattu Medical College Hospital from January 2018 to December 2018. The study design was descriptive study. A detailed history taking, thorough clinical examination and appropriate relevant investigations were done.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age group of the 120 patients (male-56, female-64) was 35 years. Segmental distribution: Thoracic-60%, cervical-6%, lumbosacral-2%, herpes zoster ophthalmicus-22%, herpes zoster oticus-10%. 34% were diabetic, 2% HIV, 4% following surgery/trauma, 10% on steroid therapy. 13% had history of native treatment. Prodromal symptoms in 34%, post herpetic neuralgia-60%, sepsis in 52%.</p><p class="abstract"><strong>Conclusions:</strong> Herpes zoster occurs in dermatomes in which the rash of varicella achieves highest intensity. Herpes zoster can affect any age group with a higher incidence in elderly patients and in those with immuno-compromised status, treatment with antivirals within 72 hours of onset of rash has shown a reduction in severity and complications.</p>

scholarly journals Does Herpes Zoster Increase the Risk of Stroke and Myocardial Infarction? A Comprehensive Review

2019 ◽  
Vol 8 (4) ◽  
pp. 547 ◽  
Author(s):  
Ping-Hsun Wu ◽  
Yun-Shiuan Chuang ◽  
Yi-Ting Lin
Keyword(s):  
Myocardial Infarction ◽  
Herpes Zoster ◽  
Antiviral Treatment ◽  
Cardiac Events ◽  
Herpes Zoster Ophthalmicus ◽  
Varicella Zoster ◽  
Vesicular Rash ◽  
Ischemic Complications ◽  
One Year ◽  
Ischemic Attack

Herpes zoster (HZ) caused by varicella zoster virus (VZV) reactivation is characterized as a vesicular rash of unilateral distribution that can also cause multiple complications; such as post-herpetic neuralgia; ophthalmic zoster; and other neurological issues. VZV can also increase incident hemorrhagic or ischemic complications by causing inflammatory vasculopathy. Thus; emerging epidemiological and clinical data recognizes an association between HZ and subsequent acute strokes or myocardial infarction (MI). This study reviewed published articles to elucidate the association between HZ and cerebrovascular and cardiac events. Individuals exposed to HZ or herpes zoster ophthalmicus had 1.3 to 4-fold increased risks of cerebrovascular events. Higher risks were noted among younger patients (age < 40 years) within one year after an HZ episode. The elevated risk of CV events diminished gradually according to age and length of time after an HZ episode. The putative mechanisms of VZV vasculopathy were also discussed. Several studies showed that the development of herpes zoster and herpes zoster ophthalmicus increased the risks of stroke; transient ischemic attack; and acute cardiac events. The association between VZV infection and cardiovascular events requires further studies to establish the optimal antiviral treatment and zoster vaccination to reduce zoster-associated vascular risk

scholarly journals Varicella‐Zoster Virus–Specific Immune Responses to Herpes Zoster in Elderly Participants in a Trial of a Clinically Effective Zoster Vaccine

2009 ◽  
Vol 200 (7) ◽  
pp. 1068-1077 ◽  
Author(s):  
Adriana Weinberg ◽  
Jane H. Zhang ◽  
Michael N. Oxman ◽  
Gary R. Johnson ◽  
Anthony R. Hayward ◽  
...  
Keyword(s):  
Herpes Zoster ◽  
Immune Responses ◽  
Varicella Zoster Virus ◽  
Zoster Vaccine ◽  
Varicella Zoster

Herpes Zoster Ophthalmicus—Diagnosis and Management

2013 ◽  
Vol 06 (02) ◽  
pp. 1 ◽  
Author(s):  
Antoine Rousseau ◽  
Tristan Bourcier ◽  
Joseph Colin ◽  
Marc Labetoulle ◽  
◽  
...  
Keyword(s):  
Herpes Zoster ◽  
General Population ◽  
Viral Replication ◽  
Varicella Zoster Virus ◽  
Lifetime Risk ◽  
Herpes Zoster Ophthalmicus ◽  
Ocular Complications ◽  
Varicella Zoster ◽  
Diagnosis And Management

Varicella-zoster virus (VZV) infections are widely distributed in the general population. The lifetime risk of herpes zoster is estimated to be 10–20 %, increasing with age (1–4). Since herpes zoster ophthalmicus (HZO) accounts for 20 % of all locations of shingles, the lifetime risk of HZO is about 1–2 %. The management of ocular complications of VZV infection is now well codified, but sequellae still can occur, despite an armamentarium effective in limiting viral replication and its immune consequences.

scholarly journals Comparison of the Levels of Immunogenicity and Safety of Zostavax in Adults 50 to 59 Years Old and in Adults 60 Years Old or Older

2009 ◽  
Vol 16 (5) ◽  
pp. 646-652 ◽  
Author(s):  
Santosh C. Sutradhar ◽  
William W. B. Wang ◽  
Katia Schlienger ◽  
Jon E. Stek ◽  
Jin Xu ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Herpes Zoster ◽  
Lower Bound ◽  
Confidence Interval ◽  
Geometric Mean ◽  
Age Groups ◽  
Safety Data ◽  
Enzyme Linked Immunosorbent Assay ◽  
Varicella Zoster ◽  
Adverse Experiences

ABSTRACT Zostavax has been shown to be efficacious in the prevention of herpes zoster and generally well tolerated in clinical trials among subjects 60 years old or older. This prespecified combined analysis from two studies compares the levels of immunogenicity and safety of Zostavax in subjects 50 to 59 years old versus those in subjects ≥60 years old. Varicella-zoster virus (VZV) antibody (Ab) titers were measured by glycoprotein enzyme-linked immunosorbent assay at baseline and 4 weeks postvaccination. Noninferiority was evaluated by estimated geometric mean severalfold rise (GMFR) ratio (50 to 59 years old/≥60 years old) and two-sided 95% confidence interval (CI). Success was defined by a lower bound (LB) of the 95% CI of the GMFR ratio of >0.67. Acceptability of postvaccination VZV Ab was defined by an LB of the 95% CI of the GMFR of >1.4. Safety data were recorded for 28 days postvaccination by standardized vaccination report card. The estimated GMFRs from baseline to 4 weeks postvaccination were 2.6 (95% CI, 2.4, 2.9) in subjects 50 to 59 years old and 2.3 (95% CI, 2.1, 2.4) in subjects ≥60 years old. The estimated GMFR ratio (50 to 59 years old/≥60 years old) was 1.13 (95% CI, 1.02, 1.25). No serious Zostavax-related adverse experiences were reported. After a dose of Zostavax, the GMFR of the VZV Ab response in subjects 50 to 59 years old was noninferior to that in subjects ≥60 years old. The VZV Ab response was acceptable in both age groups. Zostavax was generally well tolerated in both age groups.

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