Parisa Ravanfar

Viremia in Acute Herpes Zoster

BACKGROUND A phase 2 trial was conducted to evaluate the efficacy of a topical antiviral, sorivudine, as an adjuvant to valacyclovir for the treatment of acute herpes zoster. METHODS In this randomized, placebo-controlled, double-blind trial, 25 patients were treated with either sorivudine or placebo cream. All patients began 7 days of valacyclovir treatment on day 3. Zoster lesion swab samples and samples of peripheral blood mononuclear cells were collected periodically throughout the study and were analyzed for varicella-zoster virus (VZV) DNA by use of both qualitative and real-time polymerase chain reaction. Serum samples collected periodically throughout the study were analyzed for VZV DNA by use of real-time polymerase chain reaction. RESULTS VZV DNA was detected in all 3 sample types, and the number of viral copies correlated with the progression of herpes zoster. No statistically significant differences were seen between the placebo- and sorivudine-treated groups with respect to clinical characteristics or laboratory test results. CONCLUSION The detection of VZV DNA in the serum and peripheral blood mononuclear cells of all 25 zoster patients documents that viremia is a common manifestation of herpes zoster. Sorivudine cream appears to be a safe and well-tolerated adjuvant therapy; however, further phase 2 studies are needed to determine its clinical efficacy for the treatment of herpes zoster. Trials registration. ClinicalTrials.gov identifier: NCT00652184.

Existing antiviral vaccines

The innovation of vaccines has allowed for one of the greatest advancements in the history of public health. The first of the vaccines have been the antiviral vaccines, in particular the smallpox vaccine that was first developed by Edward Jenner in 1796. This article will review vaccination for the following viral diseases: measles, mumps, rubella, polio, hepatitis A, hepatitis B, influenza, rotavirus, rabies, monkeypox, smallpox, Japanese encephalitis, and yellow fever.

Existing antibacterial vaccines.

There are countless bacterial pathogens that cause disease in humans. Many of these bacterial infections not only cause significant morbidity and mortality in the human population but also cause a significant economic impact on society. Vaccines allow for reduction and potential eradication of such diseases. This article will review the currently approved antibacterial vaccines, which are vaccines for pertussis, tetanus, diphtheria, meningococcus, pneumococcus, Haemophilus influenza, cholera, typhoid, and anthrax.

Varicella zoster vaccines.

In the past, the varicella zoster virus affected virtually the entire population and had substantial morbidity and mortality associated with both primary varicella and herpes zoster reactivation. Since the varicella vaccine was first approved in 1995, there has been a significant decline in incidence, morbidity, and mortality caused by primary varicella. Breakthrough disease with the one‐dose vaccine schedule led to the recommendation in 2006 that children receive a two‐dose vaccine series. Older adults have also benefited from the development of the zoster vaccine. In 2006, the Food and Drug Administration approved the zoster vaccine, a higher concentration of the same live attenuated virus used in the primary varicella vaccine, for persons 60 years of age or older. It has the potential to help millions of people avoid the pain associated with reactivation of the varicella zoster virus by reducing the incidence and severity of herpes zoster and postherpetic neuralgia.

HIV vaccines under study

Human immunodeficiency virus (HIV) infection is a worldwide epidemic, with over 42 million people currently infected. Since the discovery of HIV as the causative agent of the acquired immune deficiency syndrome (AIDS), many potential vaccines have been created. The first of these vaccines presented disappointing results; however, that has not deterred researchers from continuing to develop more potential HIV vaccines. This article will review the various current HIV vaccine candidates under study.

Human papillomavirus vaccines

Cervical and other cancers linked to the human papillomavirus (HPV) are a cause of significant morbidity and mortality. Since the discovery of HPV as a cause of these cancers, there has been much research and development in the field of HPV vaccination. Two current prophylactic vaccines have proved highly effective in preventing disease because of the vaccine types. Recent advances in prophylactic and therapeutic vaccines are discussed.

Syphilis and HIV

The incidence of syphilis has decreased since the introduction of penicillin and subsequent preventive measures. With the emergence of human immunodeficiency virus (HIV), syphilis has resurged as a significant disease. Diagnosis of syphilis is further complicated by the vast array of clinical manifestations due to coinfection with HIV. It is crucial to identify its clinical manifestations, diagnosis, and treatment in order to avoid its complicationsin patients coinfected with HIV. This chapter includes the epidemiology, clinical manifestations, diagnosis, and treatment of coinfection of syphilis andHIV.

Sexual Behavior and Psychological Aspects Associated with Sexually Transmitted Infections

While the incidence of sexually transmitted infections (STIs) is largely dependent on the distribution and prevalence of infection in the population, it is also important to consider the behavior of an individual and his or her partner(s), as well as their psychological state. The term “sexual behavior” encompasses many components including sexual experience and activity, age at sexual debut, current and lifetime number of sexual partners, frequency of sexual intercourse, consistency of sexual activity, mode of recruitment of sexual partners, duration of sexual relationships, and types of sexual practice. Some behaviors and practices that are associated with an increased risk of STIs include unprotected intercourse, receptive anal intercourse, having multiple and concurrent partners, and drug and alcohol use. Psychological factors, such as mood, mental health, and even personality types, may affect both risk of contracting STIs and presentation for and response to treatment.