Pinquier Didier, Lécuyer Aurélie, Levy Corinne, Gagneur Arnaud, Pradat Pierre, Soubeyrand Benoît, Grimprel Emmanuel
Pôle Mère-Femme-Enfant, Pédiatrie Néonatale et Réanimation, CHU Rouen, France.
Hum Vaccin. 2011 May;7(5):534-8. doi: 10.4161/hv.7.5.14820. Epub 2011 May 1.
Varicella, a widespread disease of childhood, is usually benign but may in some instances lead to complications and eventually death. The aim of this study was to assess whether varicella severity in infants below one year of age was associated with the level of anti-varicella zoster virus (VZV) maternal antibodies. Two different data sets were used. Data on varicella-associated complications were collected through a national surveillance network involving 175 hospital-based pediatric wards. Data on levels of maternal acquired antibodies according to infants' age were extracted from a cohort of 345 full term infants enrolled in a prospective multicenter study in seven pediatric wards and/or pediatric emergency units. Among infants hospitalized for varicella complications, the overall prevalence of complications increased regularly from 10.4% in infants below 1 month of age to over 72.4% at 5 months of age. Conversely, the mean antibody titre decreased from 536 mIU/mL in the [0-1 [month group to below the 150 mIU/mL threshold at 3-4 months [Pearson coefficient = -0.956 (p < 0.001)]. Based on large numbers of infants, our results show for the first time, a strong inverse correlation between the levels of circulating anti-VZV maternal antibodies in full term infants and occurrence of varicella complications below one year of age. Infant protection could be optimized by increasing herd immunity, reducing the susceptibility of women in childbearing age and lowering the age of routine vaccination to 9 months. Additional vaccination for unprotected persons in close contact with infants below 12 months of age could be promoted.
水痘是一种常见的儿童疾病，通常为良性，但在某些情况下可能会导致并发症并最终死亡。本研究的目的是评估一岁以下婴儿的水痘严重程度是否与抗水痘带状疱疹病毒（VZV）母体抗体水平相关。使用了两个不同的数据集。通过一个涉及175个医院儿科病房的全国监测网络收集了水痘相关并发症的数据。根据婴儿年龄的母体获得性抗体水平数据是从在七个儿科病房和/或儿科急诊室进行的一项前瞻性多中心研究中招募的345名足月婴儿队列中提取的。在因水痘并发症住院的婴儿中，并发症的总体患病率从1个月以下婴儿的10.4%稳步上升至5个月时的超过72.4%。相反，平均抗体滴度从[0 - 1[月组的536 mIU/mL降至3 - 4个月时低于150 mIU/mL的阈值[皮尔逊系数 = -0.956（p < 0.001）]。基于大量婴儿的数据，我们的结果首次表明，足月婴儿循环抗VZV母体抗体水平与一岁以下婴儿水痘并发症的发生之间存在强烈的负相关。通过提高群体免疫力、降低育龄妇女的易感性以及将常规疫苗接种年龄降至9个月，可以优化对婴儿的保护。可以推广对与12个月以下婴儿密切接触的未受保护人员进行额外接种。
