The treatment of varicella-zoster virus infection and its complications

Abstract

Background: Varicella, zoster and their complications remain important causes of morbidity and mortality in a population containing increasing numbers of elderly or immunocompromised individuals. Objective: To review varicella-zoster virus pathogenesis and current therapeutic options. Methods: The English-language literature related to varicella-zoster virus, its associated diseases, complications and treatments was identified using the Pubmed search engine, examination of reference lists of reviewed articles and the authors' personal knowledge. Focus was placed on those studies and meta-analyses performed within the past 5 years. Results/conclusions: Antiviral agents may be used to prevent or treat the complications of varicella or zoster in a variety of patient groups. The oral prodrugs valaciclovir and famciclovir have an expanding role in the management of disease. A stepwise approach to the management of post-herpetic neuralgia should be employed in affected patients with tricyclic antidepressants and α2δ ligands as first-line agents.

Keywords::

• aciclovir
• analgesia
• brivudin
• cidofovir
• corticosteroids
• famciclovir
• foscarnet
• gabapentin
• lidocaine
• opioids
• penciclovir
• post-herpetic neuralgia
• pregabalin
• tricyclic antidepressants
• valaciclovir
• varicella
• varicella-zoster virus
• zoster

Acknowledgements

The authors would like to acknowledge the helpful contribution of Dr Robert Johnson in the preparation of this review.