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Infeção pelo vírus HHV-3 num hospital terciário : um estudo retrospetivo
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Introdução e objetivos: O herpes zóster é uma síndrome viral causada pela reativação do vírus varicella-zoster. O principal fator de risco é a idade avançada, sendo que os doentes imunocomprometidos apresentam também maior suscetibilidade a formas mais graves da doença. Frequentemente, a apresentação clínica é suficiente para estabelecer o diagnóstico, quer da varicela, quer do herpes zóster. A confirmação laboratorial por técnicas de biologia molecular, no entanto, é útil em infeções recorrentes ou apresentações atípicas, sobretudo em imunocomprometidos. Este estudo tem por objetivo caraterizar os doentes com infeção pelo HHV-3, com confirmação laboratorial, no Centro Hospitalar Universitário Lisboa-Norte, entre 2017 e 2023. Material e métodos: Foi realizado um estudo observacional retrospectivo que analisou todos os doentes com diagnóstico de infeção pelo HHV-3 confirmada laboratorialmente, no Centro Hospitalar Universitário Lisboa-Norte, no período compreendido entre 2017 e 2023. Resultados: No CHULN, entre 2017 e 2023, foram confirmados laboratorialmente sessenta e nove casos de infeção pelo HHV-3. A maioria dos doentes tinha idades entre os 50 e os 79 anos. Cerca de 16% dos doentes foram considerados imunocomprometidos. 14% dos doentes sofreram complicações, a maioria com necessidade de internamento. Cerca de 74% dos doentes foram observados pela primeira vez no serviço de urgência e destes, 59% foram referenciados a consultas de dermatologia, infeciologia ou pediatria. Apenas dois doentes apresentaram sequelas, nomeadamente, nevralgia pós-herpética. Conclusão: Os resultados obtidos são concordantes com a literatura científica, demonstrando a associação entre a idade e o risco de complicações do HZ, bem como a morbilidade relacionada com a nevralgia pós-herpética. Seria relevante estabelecer a incidência efetiva do herpes zóster em Portugal e realizar estudos de custo-eficácia para averiguar a eventual necessidade de recomendar a vacinação de indivíduos de risco.
Introduction and objectives: Herpes zoster is a viral syndrome caused by the reactivation of the varicella-zoster virus. The virus remains dormant on the dorsal root ganglia or the roots of cranial nerves after a previous infection known as varicella or chickenpox. Advancing age is the main risk factor for HZ and immunocompromised patients are the most susceptible to severe forms of the disease. Clinical presentation is often enough to diagnose varicella and HZ. However, molecular biology tests based on PCR are useful for recurrent infections or atypical presentations in immunocompromised patients. This study aimed to characterize patients diagnosed with HHV-3 infection confirmed by PCR testing at Centro Hospitalar Universitário Lisboa-Norte, between 2017 and 2023. Material and methods: A retrospective observational study was conducted to characterize all the patients diagnosed with HHV-3 infection confirmed by PCR testing at Centro Hospitalar Universitário Lisboa-Norte between 2017 and 2023. Results: Sixty-nine cases of HHV-3 infection confirmed by PCR testing were reported in CHULN between 2017 and 2023. Most patients fell withing the age bracket of 50-79 years old. 16% of patients were considered immunocompromised. 14% of patients suffered complications, with the majority requiring hospitalization. Urgent care was the first point of contact with healthcare services in 74% of cases, with 59% of patients being referred to other specialties, namely dermatology, infectious disease, and pediatrics. Only two patients suffered sequelae, particularly post-herpetic neuralgia. Conclusions: The results obtained are in agreeance with current evidence, demonstrating an association between advancing age and the risk of complications and morbidity of HZ, namely related to post-herpetic neuralgia. Knowledge of the effective incidence of HZ would be relevant, as would a cost-benefit analysis to establish the necessity to recommend vaccination in at-risk populations.
Introduction and objectives: Herpes zoster is a viral syndrome caused by the reactivation of the varicella-zoster virus. The virus remains dormant on the dorsal root ganglia or the roots of cranial nerves after a previous infection known as varicella or chickenpox. Advancing age is the main risk factor for HZ and immunocompromised patients are the most susceptible to severe forms of the disease. Clinical presentation is often enough to diagnose varicella and HZ. However, molecular biology tests based on PCR are useful for recurrent infections or atypical presentations in immunocompromised patients. This study aimed to characterize patients diagnosed with HHV-3 infection confirmed by PCR testing at Centro Hospitalar Universitário Lisboa-Norte, between 2017 and 2023. Material and methods: A retrospective observational study was conducted to characterize all the patients diagnosed with HHV-3 infection confirmed by PCR testing at Centro Hospitalar Universitário Lisboa-Norte between 2017 and 2023. Results: Sixty-nine cases of HHV-3 infection confirmed by PCR testing were reported in CHULN between 2017 and 2023. Most patients fell withing the age bracket of 50-79 years old. 16% of patients were considered immunocompromised. 14% of patients suffered complications, with the majority requiring hospitalization. Urgent care was the first point of contact with healthcare services in 74% of cases, with 59% of patients being referred to other specialties, namely dermatology, infectious disease, and pediatrics. Only two patients suffered sequelae, particularly post-herpetic neuralgia. Conclusions: The results obtained are in agreeance with current evidence, demonstrating an association between advancing age and the risk of complications and morbidity of HZ, namely related to post-herpetic neuralgia. Knowledge of the effective incidence of HZ would be relevant, as would a cost-benefit analysis to establish the necessity to recommend vaccination in at-risk populations.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2024
Palavras-chave
Herpes zóster Complicações Referenciação Nevralgia pós-herpética Vacinação Dermatologia