Thomas Sara L, Hall Andrew J
Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK.
Lancet Infect Dis. 2004 Jan;4(1):26-33. doi: 10.1016/s1473-3099(03)00857-0.
Reactivation of latent varicella zoster virus as herpes zoster is thought to result from waning of specific cell-mediated immunity, but little is known about its determinants in individuals with no underlying immunosuppression. We systematically reviewed studies of zoster epidemiology in adults and analysed data from a large morbidity study to identify factors that might be modulated to reduce the risk of zoster. Annual zoster incidence in population-based studies varied from 3.6-14.2/10(3) in the oldest individuals. Risk factors identified in analytical studies that could explain this variation included age, sex, ethnicity, genetic susceptibility, exogenous boosting of immunity from varicella contacts, underlying cell-mediated immune disorders, mechanical trauma, psychological stress, and immunotoxin exposure. Our review highlights the lack of information about risk factors for zoster. We suggest areas of research that could lead to interventions to limit the incidence of zoster. Such research might also help to identify risk factors for age-related immune decline.
潜伏的水痘带状疱疹病毒再激活引发带状疱疹，被认为是特定细胞介导免疫功能衰退所致，但对于无潜在免疫抑制的个体，其决定因素却知之甚少。我们系统回顾了成人带状疱疹流行病学研究，并分析了一项大型发病率研究的数据，以确定可能通过调节来降低带状疱疹风险的因素。在基于人群的研究中，最年长者的带状疱疹年发病率在3.6 - 14.2/10³之间。分析研究中确定的可解释这种差异的危险因素包括年龄、性别、种族、遗传易感性、水痘接触导致的外源性免疫增强、潜在的细胞介导免疫紊乱、机械创伤、心理压力和免疫毒素暴露。我们的综述凸显了关于带状疱疹危险因素信息的匮乏。我们提出了一些研究领域，这些研究可能会带来限制带状疱疹发病率的干预措施。此类研究也可能有助于识别与年龄相关的免疫衰退的危险因素。
