1: Cleve Clin J Med. 2009 Mar;76(3):152. Shingles vaccine ((JANUARY 2009). Hirsch R. PMID: 19258459 [PubMed - in process] 2: Eur J Dermatol. 2009 Mar 2. [Epub ahead of print] Herpes zoster occurring as a solitary vesicular in malignant lymphoma. Ishida N, Watanabe D, Kuhara T, Takama H, Tamada Y, Matsumoto Y. PMID: 19258238 [PubMed - as supplied by publisher] 3: Mayo Clin Proc. 2009 Mar;84(3):274-80. Herpes zoster (shingles) and postherpetic neuralgia. Sampathkumar P, Drage LA, Martin DP. Division of Infectious Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55905. sampathkumar.priya@mayo.edu. Herpes zoster (HZ), commonly called shingles, is a distinctive syndrome caused by reactivation of varicella zoster virus (VZV). This reactivation occurs when immunity to VZV declines because of aging or immunosuppression. Herpes zoster can occur at any age but most commonly affects the elderly population. Postherpetic neuralgia (PHN), defined as pain persisting more than 3 months after the rash has healed, is a debilitating and difficult to manage consequence of HZ. The diagnosis of HZ is usually made clinically on the basis of the characteristic appearance of the rash. Early recognition and treatment can reduce acute symptoms and may also reduce PHN. A live, attenuated vaccine aimed at boosting immunity to VZV and reducing the risk of HZ is now available and is recommended for adults older than 60 years. The vaccine has been shown to reduce significantly the incidence of both HZ and PHN. The vaccine is well tolerated, with minor local injection site reactions being the most common adverse event. This review focuses on the clinical manifestations and treatment of HZ and PHN, as well as the appropriate use of the HZ vaccine. PMID: 19252116 [PubMed - in process] 4: JAAPA. 2009 Jan;22(1):45-7. Hypertension; herpes zoster. Olsen ME, Klingler AM. Nephrology & Hypertension Associates, Middlebury, Connecticut, USA. PMID: 19248361 [PubMed - in process] 5: World J Gastroenterol. 2009 Feb 28;15(8):1004-6. Severe autoimmune hepatitis triggered by varicella zoster infection. Al-Hamoudi WK. Gastroenterology and Hepatology Unit (59), Department of Medicine, King Saud University, PO Box 2925, Riyadh 11461, Saudi Arabia. walhamoudi@gmail.com. Autoimmune hepatitis (AIH) is a chronic disease of unknown etiology that is characterized by the presence of circulatory autoantibodies and inflammatory histological changes in the liver. Although the pathogenesis of AIH is not known, it is thought that, in a genetically predisposed individual, environmental factors such as viruses can trigger the autoimmune process. Herpes simplex virus, Epstein-Barr virus, measles virus, and hepatitis viruses are thought to play a role in the etiology of AIH. Proteins belonging to these viruses may be similar to the amino acid chains of different autoantigens in the liver, this causes immune cross reactions and liver tissue damage. We report a case of severe AIH following varicella zoster infection in a 23-year-old man, and speculate that, based on the molecular mimicry hypothesis, the liver damage was caused by an immune cross reaction to the viral proteins. Varicella-zoster-induced AIH has not been reported previously. PMID: 19248202 [PubMed - in process] 6: Indian J Ophthalmol. 2009 Mar-Apr;57(2):163-4. Herpes zoster ophthalmicus or Herpes zoster maxillaris? Chandravanshi SL, Rathore MK. Department of Ophthalmology, S. S. Medical College and Gandhi Memorial Hospital Rewa, M.P - 486 001, India. dr_scl@rediffmail.com. Publication Types: Letter PMID: 19237800 [PubMed - in process] 7: Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2009 Feb;17(1):214-7. [Bortezomib combined with other drugs for treating 60 cases of multiple myeloma.] [Article in Chinese] Zhong YP, Chen SL, Li X, Hu Y, Zhang JJ. Department of Hematology and Oncology, Beijing Chaoyuang Hospital, Capital Medical University, Beijing 100043, China. E-mail: zhongyp3352@126.com. The aim of this study was to investigate the efficacy and safety of bortezomib-combined with dexamethasone, methylprednisolone and other drugs in the treatment of patients with multiple myeloma (MM). 60 MM patients including 19 de novo patients, out of them 14 patients received the treatment using regimen of bortezomib in combination with thalidomide (BT), 5 patients received bortezomib-methylprednisolone regimen (BMP). Out of 41 patients with refractory or relapsed myeloma 26 cases of MM received the treatment using regimen of bortezovnib combirned with methylpreamsolone (BMP), 6 cases received the treatment using regimen of bortezomib combined with cyclophosphamide, predisone and thalidomide (BCPT), 5 cases received the treatment using regimen of bortezomib combined with cis-diaminodichloroplatimm, etoposide, cydophosphomide and dexame thecson (BDECD), 4 cases received the treatment using regimen of bortesomib combined with dexamethason (BD). Each patient received treatment of 2-8 courses at least. Response was assessed according to the criteria of the Bladè. Adverse events were graded according to the commom Toxicity Criteria, version 3.0 (NCI CTCAE, USA). The median follow-up from the start of bortezomib treatment was 9 months. The results showed that out of 19 newly aiagnosed patients, 6 cares acheieved CR, 6 cases acheived nearly CR, 5 cases acheived PR, 1 case acheived MR, resulting in an ORR of 94.7%. Out of 41 refractory or relapsed patients, 5 cases acheieved CR, 10 cases got nearly CR, 14 cases were PR and 5 cases were MR, resuling in an ORR of 82.92%. The main toxicities were fatigue, gastrointestinal disorders, peripheral neuropathy, thrombocytopenia, herpes zoster, skinrash. All adverse events were diminished by using routine ways. In couclusion, bortezomib combined with orthe drugs is a very effective regimen, its side effects are predictable and manageable. Publication Types: English Abstract PMID: 19236782 [PubMed - in process] 8: Mol Pharmacol. 2009 Feb 20. [Epub ahead of print] Human Mitochondrial Thymidine Kinase (TK-2) is Selectively Inhibited by 3'-Thiourea Derivatives of {beta}-Thymidine. Identification of residues crucial for both inhibition and catalytic activity. Balzarini J, Van Daele I, Negri A, Solaroli N, Karlsson A, Liekens S, Gago F, Van Calenbergh S. Rega Institute for Medical Research. Substituted 3'-thiourea derivatives of beta-thymidine (dThd) and 5'-thiourea derivatives of alpha-dThd have been evaluated for their inhibitory activity against recombinant human cytosolic dThd kinase-1 (TK-1), human mitochondrial TK-2, herpes simplex virus type 1 (HSV-1) TK and varicella-zoster virus (VZV) TK. Several substituted 3'-thiourea derivatives of beta-dThd proved highly inhibitory to and selective for TK-2 (IC50: 0.15-3.1 microM). The 3'-C-branched p-methylphenyl (1) and 3-CF3-4-Cl-phenyl (7) thiourea derivatives of beta-dThd showed competitive inhibition of TK-2 when dThd was used as the variable substrate (Ki: 0.40 microM and 0.05 microM, respectively) but uncompetitive inhibition in the presence of variable concentrations of ATP (Ki: 15 microM and 2.0 microM, respectively). These kinetic properties of 1 and 7 against TK-2 could be accounted for by molecular modeling showing that two hydrogen bonds can be formed between the thiourea nitrogens of 7 and the oxygens of the gamma-phosphate of ATP. The importance of several active-site residues was assessed by site-directed mutagenesis experiments on TK-2 and the related HSV-1 TK. The low Ki/Km ratios for 1 and 7 (0.38 and 0.039 against dThd, and 0.75 and 0.12 against ATP, respectively) indicate that these compounds are amongst the most potent inhibitors of TK-2 described so far. In addition, a striking close correlation was found between the inhibitory activities of the test compounds against TK-2 and Mycobacterium tuberculosis thymidylate kinase that is strongly indicative of close structural and/or functional similarities between both enzymes in relation to their mode of interaction with these nucleoside analogue inhibitors. PMID: 19233899 [PubMed - as supplied by publisher] 9: J Clin Virol. 2009 Feb 20. [Epub ahead of print] Detection of herpes viruses in children with acute appendicitis. Katzoli P, Sakellaris G, Ergazaki M, Charissis G, Spandidos DA, Sourvinos G. Laboratory of Virology, Faculty of Medicine, University of Crete, Heraklion 71003, Crete, Greece. OBJECTIVE: This study aimed to investigate the incidence of herpes simplex virus (HSV) types-1 and -2, varicella-zoster virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), human herpes virus 6 (HHV-6) and human herpes virus 7 (HHV-7) in childhood acute appendicitis. STUDY DESIGN: Polymerase chain reaction (PCR) assays were applied to detect herpes virus DNA in 38 children [11 girls and 27 boys, mean age 9 years (STD+/-2.59), range 6-14 years], who underwent an appendectomy within a 2.5-year period. Appendix, omentum and peripheral blood mononuclear cells (PBMCs) were available from each case. Of the 38 children with acute appendicitis, 20 (52.6%) had advanced (phlegmonous) acute appendicitis and 18 (47.4%) had perforated appendicitis and local peritonitis. Forty-one blood specimens from age-matched healthy children (25 female and 16 male), with clinical manifestations unrelated to viral infections served as negative controls. RESULTS: CMV was the most frequently detected virus (8/38, 21%), followed by HHV-6 (3/38, 7.9%). EBV and HSV-1 were detected, though not in all three different types of tissue specimens tested. None of the samples examined were HSV-2-, VZV- or HHV-7-positive. Of all the specimens, the omentum was the most commonly infected tissue (63.0%) while the appendix and peripheral blood specimens were found to be positive for viral infection in 60.5% and 50% of cases, respectively. The CMV IgG+ antibodies were positive in 54% of the control cases while 86% of the same group presented HHV-6 IgG+ antibodies. CONCLUSION: To the best of our knowledge, this is the first study documenting the presence of herpes virus DNA in children with acute appendicitis, suggesting that possible viral infection or reactivation is associated with childhood appendicitis. PMID: 19233720 [PubMed - as supplied by publisher] 10: Pain. 2009 Feb 20. [Epub ahead of print] Controlled release oxycodone - An evidence-based treatment for pain in acute herpes zoster. Haanpää M. Rehabilitation Centre ORTON, Tenholantie 10, FIN-00280 Helsinki, Finland; Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland. Publication Types: EDITORIAL PMID: 19233562 [PubMed - as supplied by publisher] 11: Eye. 2009 Feb 20. [Epub ahead of print] Herpes zoster ophthalmicus complicated by incomplete ophthalmoplegia and a neurotrophic ulcer. Chan EW, Sanjay S. [1] 1Department of Ophthalmology and Visual Sciences, Alexandra Hospital, Singapore, Singapore [2] 2Eye Clinic, Jurong Medical Centre, Singapore, Singapore. PMID: 19229277 [PubMed - as supplied by publisher] 12: Masui. 2009 Feb;58(2):153-9. [The effects of early nerve blocks for prevention of postherpetic neuralgia and analysis of prognostic factors] [Article in Japanese] Tajima K, Iseki M, Inada E, Miyazaki T. Department of Anesthesiology and Pain Medicine, Juntendo University of Medicine, Tokyo 113-0033. BACKGROUND: Herpes zoster causes acute pain and sometimes leads to postherpetic neuralgia (PHN). The previously reported risk factors of PHN such as old age, allodynia, paresthesia and so on are not based on evidence. Although nerve block is useful to relieve acute pain and recommended for prevention of PHN, evidence is scanty. METHODS: The patients with herpes zoster within 3 months after the onset were studied. The patient underwent nerve blocks and proper medical treatment, and were followed for up to one year. The risk factors of PHN were assessed. We evaluated whether nerve block prevented PHN. RESULTS: A total of 144 consecutive patients were studied. Twenty seven % of patients suffered PHN. Old age (> 65 y. o) and hypesthesia were confirmed to be the risk factors of PHN, whereas the intensity of acute pain was not. Patients who underwent nerve block within 1 month after the onset were less likely to suffer from PHN compared with patients of delayed nerve blocks. CONCLUSIONS: Old age, hypesthesia and delayed nerve blocks were the risk factors of PHN. Nerve blocks in the early phase of herpes zoster may be useful to prevent PHN, particularly in the younger patients. Publication Types: English Abstract PMID: 19227166 [PubMed - in process] 13: JAMA. 2009 Feb 18;301(7):774-5. Comment on: JAMA. 2009 Feb 18;301(7):737-44. Herpes zoster in the age of focused immunosuppressive therapy. Whitley RJ, Gnann JW Jr. Publication Types: Comment Editorial Research Support, N.I.H., Extramural PMID: 19224757 [PubMed - indexed for MEDLINE] 14: JAMA. 2009 Feb 18;301(7):737-44. Comment in: JAMA. 2009 Feb 18;301(7):774-5. Risk of herpes zoster in patients with rheumatoid arthritis treated with anti-TNF-alpha agents. Strangfeld A, Listing J, Herzer P, Liebhaber A, Rockwitz K, Richter C, Zink A. Epidemiology Unit, German Rheumatism Research Center, Chariteplatz 1, 10117 Berlin, Germany. strangfeld@drfz.de CONTEXT: The risk of bacterial infection is increased in patients treated with drugs that inhibit tumor necrosis factor alpha (TNF-alpha). Little is known about the reactivation of latent viral infections during treatment with TNF-alpha inhibitors. OBJECTIVE: To investigate whether TNF-alpha inhibitors together as a class, or separately as either monoclonal anti-TNF-alpha antibodies (adalimumab, infliximab) or a fusion protein (etanercept), are related to higher rates of herpes zoster in patients with rheumatoid arthritis. DESIGN, SETTING, AND PATIENTS: Patients were enrolled in the German biologics register RABBIT, a prospective cohort, between May 2001 and December 2006 at the initiation of treatment with infliximab, etanercept, adalimumab, or anakinra, or when they changed conventional disease-modifying antirheumatic drug (DMARD). Treatment, clinical status, and adverse events were assessed by rheumatologists at fixed points during follow-up. MAIN OUTCOME MEASURES: Hazard ratio (HR) of herpes zoster episodes following anti-TNF-alpha treatment. Study aims were to detect a clinically significant difference (HR, 2.0) between TNF-alpha inhibitors as a class compared with DMARDs and to detect an HR of at least 2.5 for each of 2 types of TNF-alpha inhibitors, the monoclonal antibodies or the fusion protein, compared with conventional DMARDs. RESULTS: Among 5040 patients receiving TNF-alpha inhibitors or conventional DMARDs, 86 episodes of herpes zoster occurred in 82 patients. Thirty-nine occurrences could be attributed to treatment with anti-TNF-alpha antibodies, 23 to etanercept, and 24 to conventional DMARDs. The crude incidence rate per 1000 patient-years was 11.1 (95% confidence interval [CI], 7.9-15.1) for the monoclonal antibodies, 8.9 (95% CI, 5.6-13.3) for etanercept, and 5.6 (95% CI, 3.6-8.3) for conventional DMARDs. Adjusted for age, rheumatoid arthritis severity, and glucocorticoid use, a significantly increased risk was observed for treatment with the monoclonal antibodies (HR, 1.82 [95% CI, 1.05-3.15]), although this risk was lower than the threshold for clinical significance. No significant associations were found for etanercept use (HR, 1.36 [95% CI, 0.73-2.55]) or for anti-TNF-alpha treatment (HR, 1.63 [95% CI, 0.97-2.74]) as a class. CONCLUSION: Treatment with monoclonal anti-TNF-alpha antibodies may be associated with increased risk of herpes zoster, but this requires further study. Publication Types: Research Support, Non-U.S. Gov't PMID: 19224750 [PubMed - indexed for MEDLINE] 15: Am J Clin Dermatol. 2009;10(2):73-86. doi: 10.2165/00128071-200910020-00001. Clinical implications of aging skin: cutaneous disorders in the elderly. Farage MA, Miller KW, Berardesca E, Maibach HI. The Procter & Gamble Company, Winton Hill Business Center, Cincinnati, Ohio, USA. Aging skin undergoes progressive degenerative change. Structural and physiologic changes that occur as a natural consequence of intrinsic aging combined with the effects of a lifetime of ongoing cumulative extrinsic damage and environment insult (e.g. overexposure to solar radiation) can produce a marked susceptibility to dermatologic disorders in the elderly. As skin ages, the vasculature progressively atrophies. The supporting dermis also deteriorates, with collagen and elastin fibers becoming sparse and increasingly disordered. These changes leave the elderly increasingly susceptible to both vascular disorders such as stasis dermatitis and skin injuries such as pressure ulcers and skin tears, with a steadily decreasing ability to effect skin repair. A parallel erosion of normal immune function produces higher levels of autoimmune skin disorders such as bullous pemphigoid, benign mucous membrane pemphigoid, paraneoplastic pemphigoid, and pemphigus vulgaris. Lichen sclerosus, an autoimmune disorder often occurring in the genital area in older women, is not common but is an important development because of the potential for substantial discomfort as well as serious complications. The prevalence of polypharmacy in this population increases the risk for autoimmune drug reactions, and diagnosis should be undertaken with an awareness that polypharmacy in this population creates a greatly increased susceptibility to drug eruptions that can mimic other cutaneous disorders. Immunologic senescence in the elderly also sets the stage for potential reactivation of the Varicella zoster virus, in which initial dermatologic involvement expands into the major sensory ganglia. Known as shingles, this disorder can be excruciatingly painful with the potential to cause blindness if the optic nerve becomes involved. Dermatoses such as xerosis, pruritus, and eczema are also widespread in the elderly, create substantial suffering in those afflicted, and often prove recalcitrant to treatment. Individual susceptibility to specific types of contact dermatitis changes over the lifetime, and seborrheic dermatitis is substantially more prevalent in the elderly. It is not uncommon for older patients to have multiple impairments, with the potential for cognitive dysfunction as well as impaired vision, hearing, or mobility. In addition, they may not have adequate housing or nutrition, or the financial resources necessary for adequate compliance. Physicians must take into consideration the patient's physical ability to comply with the recommended therapy as well as socioeconomic factors that may impact on compliance. Simple topical regimens are preferable wherever possible in order to maximize compliance and, therefore, efficacy. Extra effort may be necessary to ensure that instructions are accurately followed and that ongoing compliance with the regimen prescribed is actually achieved. Management of dermatologic disorders in the elderly is often less than optimal, due to the fact that the special needs and limitations of this population are not adequately considered. Treatments should consider the intrinsic differences between younger and older patients that may impact on diagnosis and therapy choice. The aged patient is often afflicted with numerous co-morbidities that can influence the choice of therapy. Skin integrity in the elderly is compromised, and safety concerns are increased with the long-term use of any medication prescribed. In addition, the prevalence of polypharmacy in the aged population substantially increases the risk of cutaneous drug reactions, which can profoundly complicate accurate diagnosis of dermatologic disorders. The aged population also needs to be more closely monitored because of increased fragility of the skin and the physical limitations that may hinder compliance with prescribed regimens. PMID: 19222248 [PubMed - in process] 16: Neurology. 2009 Feb 17;72(7):670-1. Brown-Séquard syndrome after herpes zoster. Young-Barbee C, Hall DA, LoPresti JJ, Schmid DS, Gilden DH. Department of Neurology, Mail Stop B182, University of Colorado Denver School of Medicine, 4200 E. 9th Ave., Denver, CO 80262, USA. Publication Types: Research Support, N.I.H., Extramural PMID: 19221302 [PubMed - in process] 17: Cancer Biother Radiopharm. 2009 Feb 13. [Epub ahead of print] Rituximab and Chemotherapy in Primary Gastric Lymphoma. Avilés A, Castañeda C, Cleto S, Neri N, Huerta-Guzmán J, Gonzalez M, Nambo MJ. Oncology Research Unit, Oncology Hospital, National Medical Center, Mexico City, Mexico. Purpose: We perfomed a phase II clinical trial to assess the efficacy and toxicity of the addition of rituximab and conventional chemotherapy in primary gastric lymphoma (PGL). Methods: Forty-two (42) patients with PGL, stage IE and IIE, and with low- or low-intermediate clinical risk were treated in a prospective longitudinal study with standard CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy and rituximab (375 mg/m(2), intravenously) on day 1 of each cycle administered every 21 days, for 6 cycles. The endpoint was to assess improvement in outcome measured by prolongation in event-free survival (EFS) and overall survival (OS). Complete response was achieved in 40 cases (95%) (95% confidence interval [CI]: 88%-102%). Relapse was observed in 2 cases. Two (2) patients died secondary to tumor progression. Thus, actuarial 5-year EFS was 95% (95 % CI: 87%-104%) and OS was 95% (95% CI: 88%-101%), which was not statistically different to historic controls. Acute toxicity was minimal and well tolerated, 4 cases developed late toxicity, 2 cases of herpes zoster infection, and 2 cases with granulocytopenia; in 1 case, the patient continued with mild granulocytopenia 3 years after treatment. Conclusions: The addition of rituximab to CHOP chemotherapy did not improve outcome in early-stage PGL. PMID: 19216628 [PubMed - as supplied by publisher] 18: Semin Neurol. 2009 Feb;29(1):5-13. Epub 2009 Feb 12. Seventh cranial neuropathy. Gilchrist JM. Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island. Facial neuropathy, or seventh cranial neuropathy, is the most common cranial neuropathy. The anatomy of the facial nerve is rather complex for a cranial nerve, with a long intracranial course, in which the nerve takes three bends (or genu). Electrodiagnosis can be helpful in prognosis, but not before several days. Imaging is rarely indicated in Bell's palsy, but is often abnormal nonetheless, and can be very useful in other causes of facial neuropathy. The clinical presentation is of unilateral facial weakness of upper and lower face, hyperacusis, dysgeusia, and disordered lacrimation and salivation. Many different disease processes can result in facial neuropathy, but 70% of cases are idiopathic, or as it is best known, Bell's palsy. Ramsay Hunt syndrome, defined as facial neuropathy with herpes zoster oticus, is another common cause. Steroids given acutely are beneficial in improving outcome in Bell's palsy, and antiviral therapy seems helpful in more severe cases. Antiviral therapy is definitely helpful in Ramsay Hunt disease when given within 3 days of onset. Antibiotics are helpful in Lyme facial neuropathy, which has a very good prognosis. PMID: 19214928 [PubMed - in process] 19: Laryngoscope. 2009 Feb 11. [Epub ahead of print] Herpes zoster oticus associated with varicella zoster virus encephalitis. Eskiizmir G, Uz U, Taşkiran E, Unlü H. Department of Otorhinolaryngology, Celal Bayar University, Manisa, Turkey. Ramsay-Hunt syndrome, herpes zoster oticus (HZO), derived its name from James Ramsay Hunt, who first described it in 1907. It is classically characterized by acute peripheral facial paralysis, herpetic eruptions on the auricle, and vestibulocochlear dysfunction due to the reactivation of varicella zoster virus (VZV). In this Case Report, the authors describe an HZO patient with simultaneous VZV encephalitis. To date, only eight cases of HZO associated with VZV encephalitis have been reported in the English literature. Therefore, the authors discuss all the aspects of this rare entity, including clinical examination, radiological evaluation, laboratory evaluation, and treatment options. Laryngoscope, 2009. PMID: 19213041 [PubMed - as supplied by publisher] 20: J Virol. 2009 Feb 11. [Epub ahead of print] Components of Nuclear Domain 10 bodies Regulate Varicella Zoster Virus Replication. Kyratsous CA, Silverstein SJ. Department of Microbiology, College of Physicians and Surgeons, Columbia University, 701 W. 168 St., New York, New York 10032, USA. PML, Sp100 and Daxx are proteins that normally reside within Nuclear Domains 10 (ND10s). They associate with DNA virus genomes and repress the very early stages of DNA virus replication cycle. Virus encoded proteins counteract this innate anti-viral response. ICP0, a Herpes Simplex Virus (HSV) immediate early protein, is necessary and sufficient to dissociate ND10s and target their two major components PML and Sp100 for proteasomal degradation. In this report we show that ORF61p, the Varicella Zoster Virus (VZV) ortholog, does not degrade PML and only slightly alters Sp100 levels. Furthermore, we demonstrate that other virus proteins cannot substitute for this lack of function during infection. By use of short interfering RNAs we depleted PML, Sp100 and Daxx and studied their role in plaquing efficiency, virus protein accumulation, infectious center titer and virus spread. These studies show that components of ND10s can accelerate VZV replication but do not ultimately control cell-associated virus titers. We conclude that while both ICP0 and ORF61p activate virus gene expression, they modulate host innate repression mechanisms in two different ways. As a result HSV and VZV commandeer their hosts by distinct mechanisms to ensure their replication and spread. PMID: 19211749 [PubMed - as supplied by publisher]