Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Saint Maur des Fossés, France.
Eur J Pediatr. 2010 Oct;169(10):1293-7. doi: 10.1007/s00431-010-1212-9. Epub 2010 May 12.
Chickenpox is often considered more severe during the first year of life, but its course is usually mild during the first 3 months of life, presumably owing to the persistence of maternal antibodies. Hospitalization and intravenous acyclovir therapy are generally restricted to severe cases but also systematically recommended in newborns in France, irrespective of the clinical severity of the infection. This recommendation was launched in 1998 when Varicella zoster virus (VZV)-specific immunoglobulins were not available in the country and has remained unchanged since. The aim of this prospective observational study was to describe complications of varicella infection in a population of 745 children hospitalized for varicella before 1 year of age, with a specific focus on newborns. Complications occurred in 65% of cases. They were very rare before the age of 1 month (10%) but their incidence then increased progressively with age and probably the disappearance of maternal antibodies: 42% (1-2 months), 66% (3-5 months), 70% (6-8 months), and 79% (9-12 months). Conclusion Chickenpox is usually mild in newborns because most of them are protected by VZV maternal antibodies. Unless the absence of maternal VZV immunity is demonstrated, newborns with mild chickenpox should not require antiviral therapy.
水痘通常被认为在生命的第一年更为严重，但在生命的头 3 个月，其病程通常较为轻微，这可能是由于母体抗体的持续存在。住院和静脉注射阿昔洛韦治疗通常仅限于严重病例，但在法国，无论感染的临床严重程度如何，也系统地推荐给新生儿。这一建议于 1998 年推出，当时该国尚无水痘带状疱疹病毒 (VZV) 特异性免疫球蛋白，此后一直未变。这项前瞻性观察性研究的目的是描述 745 例因水痘住院的 1 岁以下儿童的水痘感染并发症，特别关注新生儿。65%的病例发生了并发症。在 1 个月前（10%），它们非常罕见，但随着年龄的增长，母体抗体的消失，其发生率逐渐增加：42%（1-2 个月）、66%（3-5 个月）、70%（6-8 个月）和 79%（9-12 个月）。结论 新生儿的水痘通常较为轻微，因为他们中的大多数人受到 VZV 母体抗体的保护。除非证明新生儿缺乏 VZV 免疫力，否则患有轻度水痘的新生儿不应需要抗病毒治疗。
