Varicella zoster virus (VZV)
Varicella zoster virus infections
Diagnosis and treatment
Diagnosis:
Identification of VZV-DNA by nucleic acid amplification techniques (NAT) in skin lesions is useful to confirm clinical diagnosis and enables differentiation of VZV vs. HSV-1 vs. HSV-2 when lesion distribution is not typical.
Identification of VZV-DNA in CSF, aqueous humor or tissue biopsy is recommended for diagnosis of infection of specific sites. Tissue antigen detection may be used when NAT is not available.
Notes on treatment:
monitor renal function and adjust drug dose in renal impairment. See also Anti-infective/ART interaction table
| Drug / Dose | Comments | |
|---|---|---|
| Primary Varicella infection (Chickenpox) and Herpes Zoster (Shingles): Not disseminated |
valaciclovir 1000 mg tid po |
Chickenpox: 5-7 days Shingles: 7-10 days |
| OR famciclovir 500 mg tid po |
||
| OR aciclovir 800 mg x 5/day po |
||
| Herpes Zoster: Disseminated |
aciclovir 10 mg/kg tid iv |
10-14 days (or until lesion resolution) |
| Encephalitis (including vasculitis), retinitis or infection of other sites | aciclovir 10-15 mg/kg tid iv |
14-21 days |