Stary A
Ludwig Boltzmann-Institut zur Erforschung infektiöser venero-dermatologischer Erkrankungen, Wien.
Hautarzt. 1991 Feb;42(2):72-6.
Chickenpox is the result of primary infection with the varicella zoster virus (VZV), which--like other herpes-viruses--has the ability to remain latent within the nervous system; reactivation then sometimes causes shingles many decades later. While chickenpox is benign in normal children, infection in the immunocompromised patient is characterized by a period of prolonged viral replication, delayed healing and a high frequency of extracutaneous manifestations, such as pneumonitis and involvement of the nervous system. Therefore, current therapeutic research efforts have focused on both the prevention of VZV infections through the development of a live, attenuated vaccine and improved therapeutic modalities. The existing antiviral drug acyclovir has been shown to be effective in reducing severe complications in risk groups. It has been generally accepted that the varicella vaccine is useful in immunocompromised children with acute leukaemia or solid malignant tumours. Healthy seronegative siblings will also benefit from the varicella vaccine. In addition, zoster hyperimmunoglobulin has also been shown to provide protection against primary VCV infection in the incubation period. Preventive and therapeutic efforts should mean that varicella will soon no larger be a medical problem even for immunocompromised patients.
水痘是由水痘带状疱疹病毒(VZV)原发感染所致,该病毒与其他疱疹病毒一样,有在神经系统内潜伏的能力;数十年后病毒再激活有时会引发带状疱疹。虽然水痘在正常儿童中是良性的,但免疫功能低下患者感染水痘的特征是病毒复制期延长、愈合延迟,且皮肤外表现(如肺炎和神经系统受累)的发生率很高。因此,目前的治疗研究工作主要集中在通过研发减毒活疫苗来预防VZV感染以及改进治疗方法上。现有的抗病毒药物阿昔洛韦已被证明可有效降低高危人群的严重并发症。一般认为水痘疫苗对患有急性白血病或实体恶性肿瘤的免疫功能低下儿童有用。健康的血清学阴性兄弟姐妹也将从水痘疫苗中受益。此外,带状疱疹高效价免疫球蛋白也已被证明可在潜伏期预防原发性VCV感染。预防和治疗措施意味着即使对免疫功能低下患者来说,水痘很快也将不再是一个医学问题。