Aziz M, Kessler H, Huhn G
Rush University Medical Center/John H Stroger Hospital of Cook County, Chicago, IL, USA.
Int J STD AIDS. 2013 Jun;24(6):433-9. doi: 10.1177/0956462412472461. Epub 2013 Jul 19.
Identification of perceptions about herpes zoster (HZ) disease, vaccine effectiveness and safety, and vaccine recommendations may impact immunization practices of physicians for HIV-infected patients. A survey was used to quantify knowledge of HZ as well as determine physician immunization perceptions and practices. There were 272/1700 respondents (16%). Correct answers for the incidence of varicella zoster virus (VZV) infection in adults and incidence of HZ in HIV-infected patients were recorded by 14% and 10% of providers, respectively. Providers reported poor knowledge of the incidence of disease recurrence in HIV-infected patients (41% correct), potency of HZ vaccine (47.5% correct) and mechanism of protection against reactivation of VZV (66% correct). Most (88%) agreed that HZ was a serious disease, and 73% believed that the burden of disease made vaccination important. A majority (75%) did not vaccinate HIV patients with HZ vaccine regardless of antiretroviral therapy status. Barriers to administration included safety concerns, concern that vaccine would not prevent HZ, risk of HZ dissemination, reimbursement issues and lack of Infectious Diseases Society of America (IDSA) guidelines. Only 38% of providers agreed that CDC guidelines were clear and 50% believed that clinical trials were needed prior to use of HZ vaccine in HIV-infected patients. Education about HZ is needed among HIV providers. Providers perceived vaccination as important, but data on vaccine safety and clear guidance from the CDC on this issue are lacking.
了解对带状疱疹（HZ）疾病、疫苗有效性和安全性以及疫苗推荐的看法，可能会影响医生对HIV感染患者的免疫接种行为。一项调查用于量化对HZ的了解程度，并确定医生的免疫接种看法和行为。共有272名/1700名受访者（16%）。分别有14%和10%的医疗服务提供者正确回答了成人水痘带状疱疹病毒（VZV）感染的发病率以及HIV感染患者中HZ的发病率。医疗服务提供者报告称，他们对HIV感染患者疾病复发的发病率（41%回答正确）、HZ疫苗的效力（47.5%回答正确）以及预防VZV再激活的保护机制（66%回答正确）了解不足。大多数（88%）人认为HZ是一种严重疾病，73%的人认为疾病负担使得接种疫苗很重要。大多数人（75%）无论抗逆转录病毒治疗状况如何，都不给HIV患者接种HZ疫苗。接种的障碍包括安全担忧、担心疫苗无法预防HZ、HZ传播风险、报销问题以及缺乏美国传染病学会（IDSA）指南。只有38%的医疗服务提供者认为疾控中心的指南清晰明了，50%的人认为在HIV感染患者中使用HZ疫苗之前需要进行临床试验。HIV医疗服务提供者需要接受关于HZ的教育。医疗服务提供者认为接种疫苗很重要，但缺乏关于疫苗安全性的数据以及疾控中心在此问题上的明确指导。
