Department of Research and Evaluation, Southern California Permanente Medical Group, Kaiser Permanente, Pasadena, CA 91101, USA.
Pediatr Infect Dis J. 2010 Mar;29(3):205-8. doi: 10.1097/INF.0b013e3181bc379b.
Previous studies of varicella-zoster virus reactivation in children have provided little information on potential risk factors. The aim of this study was to investigate the effects of race, chronic medical conditions and treatments, and recent vaccination, on the risk of herpes zoster (HZ) in children vaccinated with one dose of varicella vaccine.
Case subjects were identified from a cohort of subjects who were members of the Southern California Kaiser Permanente Health Plan and received primary immunization with a single-antigen live varicella vaccine at age < or = 12 years from 2002 to 2008. Control subjects free of HZ during the study period were matched at a 5:1 ratio to each case subject on date of birth and sex. Race information was obtained from membership files, health records, and phone interview. Immunization history, medical history, and health care utilization were identified from Southern California Kaiser Permanente Health Plan electronic records.
During this time, 122 children were diagnosed with HZ. With adjustment for the number of hospitalizations, outpatient visits, and length of time between vaccination with varicella vaccine and the onset of HZ, Black children were at lower risk of developing HZ than were White (OR=0.41, 95% CI=0.17-0.98) and Asian children (OR=0.30, 95% CI=0.11-0.84).
These data suggest that the racial differences in the risk of developing HZ seen in adults are manifest in children as well. As children are not subject to the majority of factors hypothesized to underlie HZ in adults and as this study was conducted in a setting which affords equal access to health care, it is possible that genetic variation may explain some portion of varicella-zoster virus reactivation.
先前关于水痘带状疱疹病毒（varicella-zoster virus）在儿童中重新激活的研究很少提供潜在危险因素的信息。本研究旨在调查种族、慢性疾病和治疗以及最近疫苗接种对接受一剂水痘疫苗接种的儿童发生带状疱疹（herpes zoster，HZ）的风险的影响。
从加利福尼亚州南部 Kaiser Permanente 健康计划的队列中确定病例对象，这些对象在 2002 年至 2008 年期间年龄<12 岁时接受了单抗原活水痘疫苗的初级免疫。在研究期间未发生 HZ 的对照对象按出生日期和性别与每个病例对象以 5:1 的比例匹配。种族信息从成员档案、健康记录和电话访谈中获得。免疫接种史、病史和医疗保健使用情况从加利福尼亚州南部 Kaiser Permanente 健康计划的电子记录中确定。
在此期间，有 122 名儿童被诊断出患有 HZ。在调整了住院次数、门诊就诊次数以及接种水痘疫苗与 HZ 发病之间的时间长度后，与白人（比值比[OR]=0.41，95%可信区间[CI]=0.17-0.98）和亚洲儿童（OR=0.30，95% CI=0.11-0.84）相比，黑人儿童发生 HZ 的风险较低。
这些数据表明，在成年人中观察到的 HZ 发病风险的种族差异在儿童中也存在。由于儿童不受假设导致成年人 HZ 的大多数因素的影响，并且本研究是在提供平等获得医疗保健的环境中进行的，因此遗传变异可能解释了部分水痘带状疱疹病毒重新激活的原因。
