In Herpes Zoster, acyclovir should be given if immunocompromised or within 72 hours of onset.

In Herpes Zoster, acyclovir should be given if immunocompromised or within 72 hours of onset.

• A. Not recommended
• B. Only in immunocompromised
• C. Within 72 hours of onset or if immunocompromised
• D. Only for ocular involvement

Answer: (C)

Antiviral therapy for herpes zoster is most beneficial when started early and in people at higher risk of complications. Beginning acyclovir (or alternatives like valacyclovir or famciclovir) within 72 hours of the onset of the rash reduces viral replication, speeds lesion healing, shortens the duration of pain, and lowers the risk of developing postherpetic neuralgia. This early window is important because once the eruption has progressed beyond a few days, the benefit diminishes. Immunocompromised patients are at greater risk for rapid progression and dissemination to other organs, so antiviral treatment is indicated even if the illness is not in the very early stage. In these patients, therapy helps prevent severe complications and should be started promptly, sometimes with intravenous therapy in more severe cases. Ocular involvement is a serious concern that also warrants careful management, but it is not the sole reason to treat; many shingles cases benefit from antiviral therapy, particularly when risk factors are present or treatment can be started soon after onset. Therefore, the recommended approach is to give acyclovir if the patient is immunocompromised or if treatment can be started within 72 hours of onset.

Antiviral therapy for herpes zoster is most beneficial when started early and in people at higher risk of complications. Beginning acyclovir (or alternatives like valacyclovir or famciclovir) within 72 hours of the onset of the rash reduces viral replication, speeds lesion healing, shortens the duration of pain, and lowers the risk of developing postherpetic neuralgia. This early window is important because once the eruption has progressed beyond a few days, the benefit diminishes.

Immunocompromised patients are at greater risk for rapid progression and dissemination to other organs, so antiviral treatment is indicated even if the illness is not in the very early stage. In these patients, therapy helps prevent severe complications and should be started promptly, sometimes with intravenous therapy in more severe cases.

Ocular involvement is a serious concern that also warrants careful management, but it is not the sole reason to treat; many shingles cases benefit from antiviral therapy, particularly when risk factors are present or treatment can be started soon after onset. Therefore, the recommended approach is to give acyclovir if the patient is immunocompromised or if treatment can be started within 72 hours of onset.