Varicella Zoster Virus (VZV)

Varicella zoster virus infections

Treatment

Diagnosis: typical clinical appearance with/without antibody testing, OR antigen testing / PCR / culture of swab / CSF / biopsy

During treatment: monitor renal function, adjust drug dose in renal impairment

  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 clinical improvement)
Encephalitis (including vasculitis),
retinitis
aciclovir
10-15 mg/kg tid iv

14-21 days
If retinitis, consult ophthalmologist