Ansaldi Filippo, Trucchi Cecilia, Alicino Cristiano, Paganino Chiara, Orsi Andrea, Icardi Giancarlo
Department of Health Sciences, University of Genoa, Genoa, Italy.
IRCCS University Hospital "San Martino"-IST National Institute for Cancer Research, Genoa, Italy.
Adv Ther. 2016 Jul;33(7):1094-104. doi: 10.1007/s12325-016-0355-0. Epub 2016 Jun 4.
Herpes zoster (HZ) is a common, painful and debilitating disease caused by the reactivation of latent varicella-zoster virus in ganglia. This clinical event occurs more frequently in the elderly and those who are immunocompromised. The most common complication of HZ is post-herpetic neuralgia (PHN) which is responsible for the highest HZ-related burden of illness and is challenging to treat. Due to the important clinical and economic impact of HZ and PHN, and the suboptimal treatments that are currently available, HZ vaccination is an important approach to reduce the burden of illness. Currently, one-dose, live-attenuated vaccine is licensed in the United States and Europe to prevent HZ and it is included in some national immunization programs. The clinical efficacy, safety and tolerability of the vaccine has been demonstrated in two large phase III clinical trials, involving more than 38,000 and 22,000 individuals aged ≥60 and 50-59 years, respectively. This comprehensive review summarizes the extensive "real-world" effectiveness and safety data from both immunocompetent and immunocompromised individuals. These data confirm those from the clinical trials, supporting the use of HZ vaccine in clinical practice and provide evidence that the current recommendations for immunocompromised individuals should be revised.
Funding for the editorial assistance, article processing charges, and open access fee for this publication was provided by Sanofi Pasteur MSD.
带状疱疹(HZ)是一种由神经节中潜伏的水痘-带状疱疹病毒重新激活引起的常见、疼痛且使人衰弱的疾病。这种临床情况在老年人和免疫功能低下者中更频繁发生。HZ最常见的并发症是带状疱疹后神经痛(PHN),它是HZ相关疾病负担最高的原因,且治疗具有挑战性。由于HZ和PHN具有重要的临床和经济影响,以及目前可用的治疗效果欠佳,HZ疫苗接种是减轻疾病负担的重要方法。目前,单剂量减毒活疫苗在美国和欧洲已获许可用于预防HZ,并且被纳入一些国家免疫规划。该疫苗的临床疗效、安全性和耐受性已在两项大型III期临床试验中得到证实,这两项试验分别涉及超过38000名60岁及以上个体和22000名50 - 59岁个体。这篇综述总结了来自免疫功能正常和免疫功能低下个体的广泛“真实世界”有效性和安全性数据。这些数据证实了临床试验的数据,支持在临床实践中使用HZ疫苗,并提供证据表明当前针对免疫功能低下个体的建议应予以修订。
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