title: Human herpes viruses in burn patients: A systematic review.
abstract: OBJECTIVE
  The contribution of human herpes viruses, including herpes simplex virus (HSV), cytomegalovirus (CMV), and varicella zoster virus (VZV) to morbidity and mortality after burns remains controversial. This systematic review was undertaken to assess evidence of herpes virus-related morbidity and mortality in burns.
  
  
  METHODS
  PubMed, Ovid, and Web of Science were searched to identify studies of HSV, CMV, or VZV infections in burn patients. Exclusion criteria included: A level of evidence (LoE) of IV or V; nonhuman in vivo studies; and non-English articles. There was no limitation by publication date.
  
  
  RESULTS
  Fifty articles were subjected to full-text analysis. Of these, 18 had LoE between I-III and were included in the final review (2 LoE I, 16 LoE II-III). Eight had a prospective study design, 9 had a retrospective study design, and 1 included both.
  
  
  CONCLUSIONS
  No direct evidence linked CMV and HSV infection with increased morbidity and mortality in burns. Following burn, CMV reactivation was more common than a primary CMV infection. Active HSV infection impaired wound healing but was not directly correlated to mortality. Infections with VZV are rare after burns but when they occur, VZV infections were associated with severe complications including mortality. The therapeutic effect of antiviral agents administered after burns warrants investigation via prospective randomized controlled trials.
authors: Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX, USA; Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria. Electronic address: wurzer_paul@gmx.at.
authors: Paul
authors: P
authors: Wurzer
authors: Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX, USA.
authors: Ashley
authors: A
authors: Guillory
authors: Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
authors: Daryousch
authors: D
authors: Parvizi
authors: Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX, USA; Sealy Center for Molecular Medicine and the Institute for Translational Sciences, University of Texas Medical Branch, Galveston, TX, USA.
authors: Robert P
authors: RP
authors: Clayton
authors: Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX, USA; Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
authors: Ludwik K
authors: LK
authors: Branski
authors: Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
authors: Lars-P
authors: LP
authors: Kamolz
authors: Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX, USA; Sealy Center for Molecular Medicine and the Institute for Translational Sciences, University of Texas Medical Branch, Galveston, TX, USA.
authors: Celeste C
authors: CC
authors: Finnerty
authors: Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX, USA.
authors: David N
authors: DN
authors: Herndon
authors: Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX, USA.
authors: Jong O
authors: JO
authors: Lee
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D002056:Burns / Q000453:epidemiology / Q000401:mortality / Q000821:virology*; D002644:Chickenpox / Q000188:drug therapy / Q000453:epidemiology*; D003587:Cytomegalovirus; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000453:epidemiology*; D006561:Herpes Simplex / Q000188:drug therapy / Q000453:epidemiology*; D006562:Herpes Zoster / Q000188:drug therapy / Q000453:epidemiology*; D014645:Herpesvirus 3, Human; D006801:Humans; D018139:Simplexvirus; D014775:Virus Activation
chemical_list: D000998:Antiviral Agents
keywords: Burns; Chickenpox; Cytomegalovirus; Herpes simplex virus; Human herpes virus; Varicella-zoster virus