Herpes zoster – da li su potrebne nove preporuke za lečenje?

  • Uroš Karić Clinical Center of Serbia, Clinic for Infectious and Tropical Diseases, Belgrade, Serbia University of Priština/ Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia
  • Nataša Katanić Clinical Center of Serbia, Clinic for Infectious and Tropical Diseases, Belgrade, Serbia
  • Sanja Peruničić Clinical Center of Serbia, Clinic for Infectious and Tropical Diseases, Belgrade, Serbia
  • Nikola Mitrović Clinical Center of Serbia, Clinic for Infectious and Tropical Diseases, Belgrade, Serbia
  • Nataša Nikolić Clinical Center of Serbia, Clinic for Infectious and Tropical Diseases, Belgrade, Serbia
  • Marko Marković Clinical Center of Serbia, Clinic for Infectious and Tropical Diseases, Belgrade, Serbia
  • Ksenija Bojović Clinical Center of Serbia, Clinic for Infectious and Tropical Diseases, Belgrade, Serbia
  • Jovan Malinić Clinical Center of Serbia, Clinic for Infectious and Tropical Diseases, Belgrade, Serbia
  • Jasmina Poluga Clinical Center of Serbia, Clinic for Infectious and Tropical Diseases, Belgrade, Serbia
  • Jasmina Simonović Babić Clinical Center of Serbia, Clinic for Infectious and Tropical Diseases, Belgrade, Serbia; University of Beograde, Faculty of Medicine, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP170905021K
Ključne reči: infekcija, varičela-zoster virus, recidiv, aciklovir, lekovi, korišćenje, lečenje, ishod

Sažetak


Apstrakt

 

Uvod/Cilj. Rektivacija varicela zoster virusa dovodi do herpesa zostera (HZ). Prema aktuelnim preporukama terapija ove bolesti podrazumeva 7 do 10 dana primene aciklovira. Terapiju treba započeti unutar 72 časa od pojave ospe. Ova studija imala je za cilj da proceni da li je kašnjenje u započinjanju terapije i/ili skraćeno trajanje terapije aciklovirom povezano sa lošim tokom i ishodom HZ. Metode. Sprovedena je analiza 292 bolesnika koji su lečeni zbog herpes zostera u Klinici za infektivne i tropske bolesti u Beogradu u petogodišnjem periodu. Podatke o ovim bolesnicima analizirali smo pomoću metoda deskriptivne statistike, χ2- testa, Man-Vitni U-testa i multiplom logističkom regresijom. Rezultati. Vreme od pojave ospe do prve doze aciklovira iznosilo je 4,07 ± 2,64 dana. Bolesnici su lečeni aciklovirom prosečno 6,83 ± 2,45 dana. Sedamdeset jedan bolesnik imao je diseminovanu bolest, kod 100 su bili zahvaćeni kranijalni nervi, a kod 86 su se razvile komplikacije. Jedan bolesnik je preminuo. Slučajevi kod kojih je došlo do kašnjenja u započinjanju terapije nisu bili statistički značajno povezani sa komplikacijama (χ2 = 0.031; p = 0.86). Logistička regresija nije uspela da predvidi ko je bio lečen aciklovirom više ili manje od sedam dana. Nije dokazana povezanost između komplikacija HZ i terapijskih režima kraćih od preporučenih (χ2 = 1.109; p = 0.326). Pregledom PubMed baze podataka učinjenim 1. februara 2017. godine, u do tada objavljenim studijama nismo pronašli dokaze o tome da je neophodno najmanje sedam dana terapije aciklovirom za herpes zoster.  Zaključak. Nije dokazano da je kašnjenje u započinjanju terapije aciklovirom povezano sa nepovoljnim ishodima. Isto se može reći i za kraće terapijske kure.

 

Reference

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2021/05/26
Broj časopisa
Vol. 76 Br. 11 (2019): Vojnosanit Pregl
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Originalni članak