Buccoliero Giovanni, Lonero Gaetano, Romanelli Chiara, Loperfido Pietro, Resta Francesco
S.C. Malattie Infettive, Presidio Ospedaliero Centrale, Stabilimento San G. Moscati, AUSL TA, Italia.
New Microbiol. 2010 Jul;33(3):271-4.
The introduction of targeted immunotherapies has greatly improved the therapeutic options of several inflammatory diseases such as psoriatic arthritis. However treatment-related opportunistic infections and viral reactivations may still occur. We describe a case of varicella zoster virus (VZV) encephalitis due to the reactivation of latent VZV infection during a long therapy with the anti-tumor necrosis factor-alpha (TNF-alpha) drug Adalimumab. The low incidence of VZV encephalitis in patients treated with biological agents does not justify VZV serological screening in these subjects, but careful monitoring of the patients is recommended to recognize early signs and symptoms of herpes zoster to start prompt antiviral therapy to prevent associated complications.
靶向免疫疗法的引入极大地改善了几种炎症性疾病（如银屑病关节炎）的治疗选择。然而，与治疗相关的机会性感染和病毒再激活仍可能发生。我们描述了一例在长期使用抗肿瘤坏死因子-α（TNF-α）药物阿达木单抗治疗期间，因潜伏性水痘带状疱疹病毒（VZV）感染再激活而导致的VZV脑炎病例。生物制剂治疗患者中VZV脑炎的低发病率并不足以证明对这些受试者进行VZV血清学筛查是合理的，但建议对患者进行仔细监测，以识别带状疱疹的早期体征和症状，以便开始及时的抗病毒治疗，预防相关并发症。
