Nikkels A F, Piérard G E
Department of Dermatopathology, University of Liège, Belgium.
Drugs. 1994 Oct;48(4):528-48. doi: 10.2165/00003495-199448040-00004.
Varicella zoster virus (VZV) is responsible for a primary infection (varicella) followed by a latency, eventually resulting in herpes zoster (shingles). The replication cycle of VZV is normally interrupted after varicella. Consequently, VZV remains dormant in the organism. Reactivation occurs after viraemia, and the development of tissue alterations (skin and viscera) depends on the immunological status of the patient. Diagnosis of herpes zoster relies on clinical recognition and cytological and histological evaluations combined with immunohistochemistry and molecular biology techniques. Treatment of herpes zoster primarily relies upon antiviral drugs and incidentally on immunomodulating agents, specific immunoglobulins, antimicrobial agents, antiviral enzymes and corticosteroids. Drugs with a clinically relevant activity against varicella zoster virus infections include aciclovir, adenosine monophosphate, bromodeoxyuridine, desciclovir, fiacitabine, idoxuridine, interferon-alpha and vidarabine. Among them, aciclovir appears to be a first-line agent. Its efficacy has been well established by many clinical studies. Promising drugs for the future include famciclovir, penciclovir, valaciclovir and other molecules currently under investigation. Recent and promising improvements in antiviral drug development may increase patient compliance, cost-benefit ratios and therapeutic efficacy.
水痘带状疱疹病毒（VZV）可引发初次感染（水痘），随后进入潜伏期，最终导致带状疱疹。水痘发生后，VZV的复制周期通常会中断。因此，VZV在机体中保持潜伏状态。病毒血症后会出现病毒激活，而组织病变（皮肤和内脏）的发展取决于患者的免疫状态。带状疱疹的诊断依赖于临床识别、细胞学和组织学评估，并结合免疫组织化学和分子生物学技术。带状疱疹的治疗主要依靠抗病毒药物，偶尔也会使用免疫调节剂、特异性免疫球蛋白、抗菌剂、抗病毒酶和皮质类固醇。对水痘带状疱疹病毒感染具有临床相关活性的药物包括阿昔洛韦、单磷酸腺苷、溴脱氧尿苷、地昔洛韦、法昔洛韦、碘苷、α干扰素和阿糖腺苷。其中，阿昔洛韦似乎是一线药物。许多临床研究已充分证实了其疗效。未来有前景的药物包括泛昔洛韦、喷昔洛韦、伐昔洛韦以及目前正在研究的其他分子。抗病毒药物研发方面近期取得的且颇具前景的进展可能会提高患者的依从性、成本效益比以及治疗效果。
