RESUMO
Varicella zoster virus (VZV) is an exclusively human neurotropic alphaherpesvirus. Primary infection causes varicella (chickenpox), after which virus becomes latent in cranial nerve ganglia, dorsal root ganglia, and autonomic ganglia along the entire neuraxis. Years later, in association with a decline in cell-mediated immunity in elderly and immunocompromised individuals, VZV reactivates and causes a wide range of neurologic disease. This article discusses the clinical manifestations, treatment, and prevention of VZV infection and reactivation; pathogenesis of VZV infection; and current research focusing on VZV latency, reactivation, and animal models.
Assuntos
Herpesvirus Humano 3/isolamento & purificação , Viroses/fisiopatologia , Viroses/virologia , Analgésicos Opioides/uso terapêutico , Antidepressivos/uso terapêutico , Antivirais/uso terapêutico , Varicela/fisiopatologia , Varicela/transmissão , Varicela/virologia , Gânglios/virologia , Herpes Zoster/fisiopatologia , Herpes Zoster/transmissão , Herpes Zoster/virologia , Vacina contra Herpes Zoster/administração & dosagem , Humanos , Neuralgia Pós-Herpética/tratamento farmacológico , Neuralgia Pós-Herpética/virologia , Síndrome de Necrose Retiniana Aguda/líquido cefalorraquidiano , Síndrome de Necrose Retiniana Aguda/prevenção & controle , Síndrome de Necrose Retiniana Aguda/virologia , Fatores de Tempo , Viroses/prevenção & controleAssuntos
Encefalite por Varicela Zoster/complicações , Encefalite por Varicela Zoster/diagnóstico , Doenças do Nervo Óptico/diagnóstico , Doenças do Nervo Óptico/virologia , Síndrome de Necrose Retiniana Aguda/diagnóstico , Síndrome de Necrose Retiniana Aguda/virologia , DNA Viral/líquido cefalorraquidiano , Diagnóstico Diferencial , Erros de Diagnóstico/prevenção & controle , Progressão da Doença , Encefalite por Varicela Zoster/líquido cefalorraquidiano , Reações Falso-Negativas , Infecções por HIV/complicações , Herpesvirus Humano 3/genética , Humanos , Hospedeiro Imunocomprometido/imunologia , Doenças do Nervo Óptico/líquido cefalorraquidiano , Valor Preditivo dos Testes , Síndrome de Necrose Retiniana Aguda/líquido cefalorraquidiano , Simplexvirus/genéticaRESUMO
PURPOSE: We investigated whether viral encephalitis could occur in patients with Kirisawa-Urayama type uveitis by analysing the cerebrospinal fluid (CSF). METHODS: CSF samples were aspirated from nine patients with Kirisawa-Urayama type uveitis and assayed for local antibody production and the presence of herpesvirus DNA. RESULTS: Seven cases had mild CSF pleocytosis. In six of seven cases who underwent CSF antibody analysis, we found intrathecal antibody production against herpes simplex virus or varicella-zoster virus which were the causative viruses diagnosed from intraocular fluid in each patients. Polymerase chain reaction (PCR) assay was used to search for virus DNA in the CSF of six patients, but all were negative. CONCLUSIONS: The results of this study suggest that Kirisawa-Urayama type uveitis is often accompanied with optic nerve involvement and intrathecal antibody production against causative viruses, but we could not find any viral encephalitis.
Assuntos
Anticorpos Antivirais/líquido cefalorraquidiano , DNA Viral/líquido cefalorraquidiano , Síndrome de Necrose Retiniana Aguda/líquido cefalorraquidiano , Uveíte/líquido cefalorraquidiano , Adulto , Feminino , Infecções por Herpesviridae/diagnóstico , Herpesvirus Humano 3/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome de Necrose Retiniana Aguda/imunologia , Síndrome de Necrose Retiniana Aguda/virologia , Simplexvirus/imunologia , Uveíte/imunologia , Uveíte/virologiaRESUMO
Viruses of the herpesvirus family cause acute retinal necrosis syndrome, a devastating necrotic retinitis in immunocompetent individuals. Direct proof of the viral origin of this disease may be obtained by demonstration of the virus, viral antigens, or viral DNA in biopsy specimens of retinas. In search of alternative diagnostic methods, we analyzed cerebrospinal fluid and serum with enzyme-linked immunosorbent assays for virus-specific antibody activity. Intrathecally produced viral antibodies were found in three consecutive patients with acute retinal necrosis syndrome: herpes simplex type 2 in a 30-year-old woman with a history of suspected neonatal herpes encephalitis, herpes simplex type 1 in a 35-year-old man, and varicella-zoster virus activity in a 62-year-old woman. None of the patients had clinical signs indicating an acute disorder in the central nervous system. This serologic approach seems to be of value for the diagnosis of an associated intracerebral viral infection in cases of acute retinal necrosis syndrome.