Department of Dermatology, Nara Medical University School of Medicine, Nara, Japan.
Research Foundation for Microbial Diseases of Osaka University, Kagawa, Japan.
J Am Acad Dermatol. 2016 Nov;75(5):950-956.e1. doi: 10.1016/j.jaad.2016.05.037. Epub 2016 Jul 26.
Recurrent herpes zoster (HZ) is thought to be rare, but there have been few large-scale studies of recurrent HZ.
We conducted a large-scale prospective cohort study to characterize recurrent HZ.
We examined 12,522 participants aged 50 years or older in Shozu County and followed them up for 3 years. We compared the incidence of HZ and postherpetic neuralgia, severity of skin lesions and acute pain, cell-mediated immunity, and varicella-zoster virus-specific antibody titer between primary and recurrent HZ.
A total of 401 participants developed HZ: 341 with primary HZ and 60 with recurrent HZ. Skin lesions and acute pain were significantly milder and the incidence of postherpetic neuralgia was lower in patients aged 50 to 79 years with recurrent HZ than in those with primary HZ. Varicella-zoster virus skin test induced a stronger reaction in patients aged 50 to 79 years with recurrent HZ than in those with primary HZ.
Information on previous HZ episodes was self-reported by participants, so it could not be confirmed that they actually had a history of HZ.
Recurrent HZ was associated with milder clinical symptoms than primary HZ, probably because of stronger varicella-zoster virus-specific cell-mediated immunity in the patients with recurrence.
复发性带状疱疹（HZ）被认为很少见，但鲜有关于复发性 HZ 的大规模研究。
我们进行了一项大规模的前瞻性队列研究，以明确复发性 HZ 的特征。
我们对 Shozu 县的 12522 名 50 岁及以上的参与者进行了检查，并对其随访了 3 年。我们比较了原发性和复发性 HZ 患者的 HZ 和带状疱疹后神经痛发生率、皮损和急性疼痛严重程度、细胞介导免疫以及水痘-带状疱疹病毒特异性抗体滴度。
共有 401 名参与者发生 HZ：341 名原发性 HZ 和 60 名复发性 HZ。50 至 79 岁复发性 HZ 患者的皮损和急性疼痛明显较轻，带状疱疹后神经痛发生率低于原发性 HZ 患者。50 至 79 岁复发性 HZ 患者的水痘-带状疱疹病毒皮肤试验反应强于原发性 HZ 患者。
既往 HZ 发作的信息由参与者自行报告，因此不能确认他们实际上有 HZ 病史。
复发性 HZ 的临床症状较原发性 HZ 轻，可能是因为复发性 HZ 患者的水痘-带状疱疹病毒特异性细胞介导免疫更强。
