The efficacy of early versus late treatment with acyclovir and valaciclovir on zoster-associated pain was assessed from two databases (1076 patients) that were compiled from randomized trials. Early treatment was started Herpes zoster (HZ) results from reactivation of varicella-zoster virus (VZV) in the dorsal root ganglion and is the most common sensory neurologic disease in the elderly. Although the disease can occur at any age, in the otherwise immunocompetent individual the risk of developing HZ substantially increases over the age of 50 years: it has been estimated that 50% of persons who reach the age of 85 years will have suffered at least one attack of HZ . The most troublesome symptom of HZ is pain, which occurs in most patients and, particularly in the elderly, often persists after the cutaneous manifestations of the disease have healed. Replication of VZV within the neurons causes an acute neuritis, and this, in turn, initiates changes within the central nervous system, leading to potentially chronic neuralgia. Because the nerve damage or malfunction (or both) triggered by VZV replication occurring early in acute HZ is responsible for the pathophysiology of the more persistent pain, therapy with antivirals to limit the subsequent pain of HZ must be started during the period of viral replication . Prompt presentation and diagnosis is therefore critical for effective relief of symptoms and for stopping further virus replication. This is often not achieved since most patients and their medical attendants do not recognize the prodromal pain of HZ for what it is and only present or diagnose the condition once the rash appears. Access to society journal content varies across our titles. If you have access to a journal via a society or association membership, please browse to your society journal, select an article to view, and follow the instructions in this box. Contact us if you experience any difficulty logging in.
Valacyclovir for the treatment ofherpes simplex, herpes zoster, and other viral infections. In herpes zoster, valacyclovir is more effective than acyclovir and. Varicella-zoster virus VZV infection causes two clinically distinct. We prefer valacyclovir or famciclovir compared with acyclovir given the.