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Recommendations for the Management of Herpes Zoster
Abstract
The objective of this article is to provide evidence-based recommendations for the management of patients with herpes zoster (HZ) that take into account clinical efficacy, adverse effects, impact on quality of life, and costs of treatment. Systematic literature reviews, published randomized clinical trials, existing guidelines, and the authors' clinical and research experience relevant to the management of patients with HZ were reviewed at a consensus meeting. The results of controlled trials and the clinical experience of the authors support the use of acyclovir, brivudin (where available), famciclovir, and valacyclovir as first-line antiviral therapy for the treatment of patients with HZ. Specific recommendations for the use of these medications are provided. In addition, suggestions are made for treatments that, when used in combination with antiviral therapy, may further reduce pain and other complications of HZ.
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“This situation would be the only indication for modifying antiviral therapy (intravenous instead of oral) for VZV infection (31).”
From Utilization of a Meningitis/Encephalitis PCR panel at the University Hospital Basel – a retrospective study to develop a diagnostic decision rule (2024) · cites this paper as [31]
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“It was shown that shingles without neurological involvement may cause pleocytosis as well as VZV-DNA detection in CSF (29–31).”
From Utilization of a Meningitis/Encephalitis PCR panel at the University Hospital Basel – a retrospective study to develop a diagnostic decision rule (2024) · cites this paper as [31]
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Metadata
- Authors
- Dworkin, R. H., Johnson, R. W., Breuer, J., Gnann, J. W., Levin, M. J., Backonja, M., Betts, R. F., Gershon, A. A., Haanpää, M. L., McKendrick, M. W., Nurmikko, T. J., Oaklander, A. L., Oxman, M. N., Langston, D. P., Petersen, K. L., Rowbotham, M. C., Schmader, K. E., Stacey, B. R., Tyring, S. K., Wijck, A. J. M. V., Wallace, M. S., Wassilew, S. W., & Whitley, R. J.
- Affiliations
- University of Rochester Medicine (US)
- University of Bristol (GB)
- Queen Mary University of London (GB)
- Birmingham VA Medical Center (US)
- University of Colorado Denver (US)
- Columbia University (US)
- Helsinki University Hospital (FI)
- Royal Hallamshire Hospital (GB)
- University of Liverpool (GB)
- Harvard University (US)
- University of California San Diego (US)
- University of California, San Francisco (US)
- Duke University (US)
- The University of Texas Health Science Center at Houston (US)
- Utrecht University (NL)
- Helios Klinikum Krefeld (DE)
- University of Alabama at Birmingham (US)
- Corresponding author
- Dworkin, Robert H.
- ORCID
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2007-01-01
- Volume
- 44
- Issue
- Supplement_1
- Pages
- S1-S26
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2104761404
- Cited by
- 869
- References
- 253
- Citations by year
- 2026: 34 · 2025: 39 · 2024: 48 · 2023: 51 · 2022: 51 · 2021: 46 · 2020: 46 · 2019: 37 · 2018: 48 · 2017: 52 · 2016: 43 · 2015: 46 · 2014: 50 · 2013: 52 · 2012: 43
- FWCI
- 24.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Herpesvirus Infections and Treatments
- Health Sciences › Medicine › Epidemiology › Cytomegalovirus and herpesvirus research
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Immunology Research
- Keywords
- herpes zoster, antiviral therapy, acyclovir, brivudin, famciclovir, valacyclovir, first-line therapy, postherpetic neuralgia, treatment guidelines, treatment costs, quality of life
- MeSH terms
- Valacyclovir, Famciclovir, Acyclovir, Analgesics, Anti-Inflammatory Agents, Antiviral Agents, Bromodeoxyuridine, Herpes Zoster, Humans, Immunocompetence, Valine, Herpesvirus 3, Human, 2-Aminopurine, Immunocompromised Host
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