Marshall Gary S
Division of Pediatric Infectious Diseases, University of Louisville School of Medicine, Louisville, KY, USA.
Pediatr Infect Dis J. 2009 Apr;28(4):355-62, quiz 363-4. doi: 10.1097/INF.0b013e318199494a.
Rotavirus is the most common cause of acute infectious gastroenteritis in children and is associated with substantial morbidity in the United States and morbidity and mortality in the developing world. Two orally administered vaccines, a live bovine reassortant vaccine (RV5; licensed in 2006) and a live attenuated human vaccine (RV1; licensed in 2008), are now being used in a universal infant vaccination program in the United States. There is already ecologic evidence and data from post-licensure effectiveness studies that this program will be an unequivocal success in reducing the impact of rotavirus disease. This overview presents the structure, pathogenesis, and mechanisms of natural immunity to rotavirus, key concepts in understanding the rationale behind vaccine-induced protection. The history of rotavirus vaccine development is also included, along with a discussion of the safety, efficacy, and recommended use of the approved vaccines.
轮状病毒是儿童急性感染性胃肠炎最常见的病因，在美国会导致大量发病，在发展中国家则会导致发病和死亡。两种口服疫苗，即一种活牛重配疫苗（RV5；2006年获得许可）和一种减毒活人类疫苗（RV1；2008年获得许可），目前正在美国的一项通用婴儿疫苗接种计划中使用。已有生态学证据以及许可后有效性研究的数据表明，该计划在减少轮状病毒疾病影响方面将取得明确成功。本综述介绍了轮状病毒的结构、发病机制和天然免疫机制，这些是理解疫苗诱导保护背后原理的关键概念。还包括轮状病毒疫苗的研发历史，以及对已批准疫苗的安全性、有效性和推荐用法的讨论。
