title: Varicella zoster: an update on current treatment options and future perspectives.
abstract: BACKGROUND
  Varicella zoster virus is a highly contagious virus that causes a primary infection known as varicella (chickenpox) that may reactivate years later to cause herpes zoster (HZ or shingles). After shingles heal, patients may develop post-herpetic neuralgia (PHN), neuropathic pain syndrome that can cause significant suffering for years and is often refractory to treatment.
  
  
  METHODS
  The wide range of treatment and management options for varicella, HZ and PHN are reviewed and discussed. PubMed was the database used for the literature search.
  
  
  CONCLUSIONS
  Antiviral therapy effectively treats acute varicella and HZ. However, PHN is still difficult to manage, especially with the numerous treatment measures that do not work consistently in all patients. The best approach is to prevent the complication from occurring in the first place by preventing HZ with the HZ vaccine, which have decreased the burden of illness caused by VZ and the incidence of HZ. Unlike the varicella vaccine, the uptake for the HZ vaccine is very low and thereby more patients over the age of 50 years should be encouraged to receive the vaccine to reduce the risk of developing HZ. Initiating treatment with gabapentin and antiviral concomitantly as soon as the rash develops may reduce the severity of complications but there is a lack of data showing these medications preventing the development of PHN.
authors.affiliation: The University of Texas Health Science Center, Department of Dermatology , 6655 Travis St, Suite 600, Houston, TX 77030 , USA kimshalon@gmail.com.
authors.forename: Sharon R
authors.initials: SR
authors.lastname: Kim
authors.forename: Farhan
authors.initials: F
authors.lastname: Khan
authors.forename: Marigdalia K
authors.initials: MK
authors.lastname: Ramirez-Fort
authors.forename: Christopher
authors.initials: C
authors.lastname: Downing
authors.forename: Stephen K
authors.initials: SK
authors.lastname: Tyring
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D002644:Chickenpox / Q000188:drug therapy* / Q000517:prevention & control; D019433:Chickenpox Vaccine; D024882:Drug Resistance, Viral; D006562:Herpes Zoster / Q000188:drug therapy* / Q000517:prevention & control; D014645:Herpesvirus 3, Human; D006801:Humans; D051474:Neuralgia, Postherpetic / Q000188:drug therapy / Q000517:prevention & control; D019384:Nucleic Acid Synthesis Inhibitors
chemical_list: D000998:Antiviral Agents; D019433:Chickenpox Vaccine; D019384:Nucleic Acid Synthesis Inhibitors