Cunningham Anthony L, Heineman Thomas
a Centre for Virus Research , The Westmead Institute for Medical Research and The University of Sydney , Sydney , Australia.
b Genocea Biosciences, Inc ., Cambridge , MA , USA.
Expert Rev Vaccines. 2017 Jul;16(7):1-10. doi: 10.1080/14760584.2017.1329012. Epub 2017 May 19.
Herpes zoster (HZ) causes an often severe and painful rash in older people and may be complicated by prolonged pain (postherpetic neuralgia; PHN) and by dissemination in immune-compromised patients. HZ results from reactivation of latent varicella-zoster virus (VZV) infection, often associated with age-related or other causes of decreased T cell immunity. A live attenuated vaccine boosts this immunity and provides partial protection against HZ, but this decreases with age and declines over 8 years. Areas covered: A new HZ subunit (HZ/su) vaccine combines a key surface VZV glycoprotein (E) with a T cell-boosting adjuvant system (AS01) and is administered by two intramuscular injections two months apart. Expert commentary: HZ/su showed excellent efficacy of ~90% in immunocompetent adults ≥50 and ≥70 years of age, respectively, in the ZOE-50 and ZOE-70 phase III controlled trials. Efficacy was unaffected by advancing age and persisted for >3 years. Approximately 9.5% of subjects had severe, but transient (1-2 days) injection site pain, swelling or redness. Compliance with both vaccine doses was high (95%). The vaccine will have a major impact on HZ management. Phase I-II trials showed safety and immunogenicity in severely immunocompromised patients. Phase III trial results are expected soon.
带状疱疹（HZ）在老年人中常引起严重且疼痛的皮疹，可能并发长期疼痛（带状疱疹后神经痛；PHN），并在免疫功能低下的患者中出现播散。HZ是由潜伏的水痘-带状疱疹病毒（VZV）感染重新激活引起的，这通常与年龄相关或其他导致T细胞免疫功能下降的原因有关。一种减毒活疫苗可增强这种免疫力，并提供对HZ的部分保护，但这种保护作用会随着年龄增长而降低，并在8年内逐渐减弱。涵盖领域：一种新的HZ亚单位（HZ/su）疫苗将关键的VZV表面糖蛋白（E）与一种增强T细胞的佐剂系统（AS01）相结合，通过两个月间隔的两次肌肉注射给药。专家评论：在ZOE-50和ZOE-70 III期对照试验中，HZ/su在50岁及以上和70岁及以上的免疫功能正常的成年人中分别显示出约90%的优异疗效。疗效不受年龄增长的影响，且持续超过3年。约9.
