Ther Clin Risk Manag. 2007 Aug;3(4):633-9.
Primary infection with varicella zoster virus (VZV) causes chickenpox (varicella) after which virus becomes latent in cranial nerve, dorsal root and autonomic ganglia along the entire neuraxis. Virus may later reactivate, causing shingles (zoster), characterized by pain and rash restricted to 1-3 dermatomes. More than 40% of zoster patients over age 60 develop postherpetic neuralgia (PHN), pain that persists for months to years. The socioeconomic impact of primary varicella infection has been lessened by introduction of VZV vaccine for children. However, the effect of childhood vaccination on the incidence of zoster is unknown. Virus reactivation correlates with waning cell-mediated immunity (CMI) to VZV with normal aging. Adults exposed to children with varicella may have a boost in CMI to VZV. For at least several more decades, the incidence of zoster may increase as the elderly population grows. The anticipated increase in zoster burden of illness in future decades was a major impetus for the Shingles Prevention Study, a prospective, double-blind, placebo-controlled trial of attenuated VZV vaccine to prevent zoster in older adults. This review discusses clinical and virological aspects of zoster and its complications, current treatment options, and VZV vaccine development along with its future role in disease prevention.
初次感染水痘带状疱疹病毒（VZV）后会引发水痘（带状疱疹），此后病毒会潜伏在颅神经、脊神经根和自主神经节中，沿整个脊神经轴分布。病毒随后可能会重新激活，导致带状疱疹（带状疱疹），其特征是疼痛和皮疹局限于 1-3 个皮节。60 岁以上的带状疱疹患者中有超过 40%会出现带状疱疹后神经痛（PHN），这种疼痛会持续数月甚至数年。由于儿童接种了 VZV 疫苗，原发性水痘感染的社会经济影响已经减轻。然而，儿童接种疫苗对带状疱疹发病率的影响尚不清楚。病毒的重新激活与细胞介导免疫（CMI）对 VZV 的减弱有关，这是随着年龄的正常衰老而发生的。接触有水痘儿童的成年人可能会增强对 VZV 的 CMI。至少在未来几十年内，随着老年人口的增加，带状疱疹的发病率可能会增加。未来几十年带状疱疹疾病负担的预期增加是带状疱疹预防研究的主要动力，这是一项针对老年人的、前瞻性的、双盲的、安慰剂对照的减毒 VZV 疫苗预防带状疱疹的临床试验。这篇综述讨论了带状疱疹及其并发症的临床和病毒学方面、当前的治疗选择以及 VZV 疫苗的开发，以及它在疾病预防中的未来作用。
