Herpes Virus Infection Flashcards
Main cause of oral cold sores?
HSV-1
Main cause of genital herpes?
HSV-2
Treatment for Shingles is effective within what time frame?
72 hrs since symptom onset
If a patient has shingles, when can they take the shingles vaccine?
After 1 year
Shingrix
inactived vaccine, 2 doses 2-6 months apart
Zostavax
live vaccine
Treatment for varicella virus (chicken pox)?
acyclovir QID x 5-7 days
(initiate within 24 hrs of rash onset)
How many days prior to lesions appearing is varicella virus contracted?
2 days prior.
generally takes 5-7 days for blisters to crust after appearing.
For VZV, who requires acyclovir prophylaxis?
healthy patients at risk of mod-severe varicella virus: > 12 yo, pregnant, chronic cutaneous of pulmonary disorders, receiving long-term salicylate treatment, or short/intermittent course of oral or inhaled corticosteroids
Treatment options for 1st episode of genital herpes? effective if started < 7 ds of onset
- famciclovir 250 mg TID x 10 days
- valacyclovir 1000 mg BID x 10 days
- acyclovir 5 times/day x 5-10 days
Treatment of shingles?
- acyclovir 800 mg 5 times/day x 7 days
- famciclovir 500 mg TID x 7 days
- valacyclovir 1000 mg TID x 7 days
Treatment for postherpetic neuraligia?
TCAs
gabapentinoids
SNRI (venla or duloxetinee)
Postherpetic neuralgia
complication of shingles, nerve pain that persists after shingles rash is resolved, continues for weeks to years
drug of choice for HSV encephalitis
acyclovir
treatment for immunosuppressed pt + herpes zoster
acyclovir IV 10 mg/q8h x 8 days
treatment for HSV keratoconjunctivitis for re-epithelialization of the cornea?
1st line: topical trifluridine - 1 drop q2h in cornea , then reduce to 1 drop q4h x 7 days
2nd line: idoxuridine - 1 drop q1h and q2h at night, indefinitely until improvement. continue x 5-7 days even after healing (but dont exceed 21 days)
If a patient is taking an immunosuppressant or biologic, and wants Zostavax vaccine, how long to wait before administration?
stop biologic if no current flare up, then administer zostavax after 2 MONTHS
Live herpes zoster vaccine is considered safe to administer to patients
receiving low-dose immunosuppressive therapy such as…
- methotrexate ≤0.4 mg/kg/week
- azathioprine ≤3.0 mg/kg/day
- 6-mercaptopurine ≤1.5 mg/kg/day
- prIf aednisone <20 mg/day (or equivalent)
If a patient already received Zostavax (live), can they receive Shingrix?
Yes, if they are 65+ years old, they can get Shingrix after 5 years of Zostavax
How many doses of Zostavax?
1 dose over 50 years old
How many doses of Shingrix?
2 doses, 2-6 months apart
when is suppressive antiviral management initiated in pregnancy for genital herpes?
36 weeks
What are some factors that can increase risk for genital herpes?
stress
systemic lupus (or immunosuppression)
female
unprotected sex/multiple partners
