School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
National Centre for Immunisation Research and Surveillance, Westmead, Australia; Discipline of Child and Adolescent Health, University of Sydney, Sydney, Australia.
J Am Acad Dermatol. 2021 Sep;85(3):611-618. doi: 10.1016/j.jaad.2020.06.1013. Epub 2020 Jul 2.
There are limited data on zoster recurrence.
To examine in detail zoster recurrence in a population-based cohort.
Using data from a large cohort (The 45 and Up Study) with linked medical data (2004-2015), the incidences of first and recurrent zoster were examined by using survival analysis methods.
Over 1,846,572 person-years of follow-up, of 17,413 participants who had a first zoster episode (incidence, 9.43 per 1000 person-years; 95% confidence interval, 9.29-9.57), 675 (3.9%) experienced a recurrence. The mean time between first and recurrent zoster was 2 years for those aged 45-54 years and 3 years for those aged 55 years and older. Among those with a first zoster, the incidence of recurrence was 11.05 (95% confidence interval, 10.24-11.91) per 1000 person-years, and higher recurrence incidence occurred in women compared to men, in younger compared to older participants, and in immunosuppressed compared to nonimmunosuppressed participants. Recurrence appeared lower in the 12 months after zoster onset but then remained consistent at approximately 12.00 per 1000 person-years in the following 8 years.
Recurrence may be underestimated because of the use of administrative data for case ascertainment. Potential misclassification of nonimmunosuppressed participants.
Our results support the vaccination of people who have already experienced zoster and underpin the need for additional studies on immunogenicity and vaccine efficacy in these populations.
带状疱疹复发的数据有限。
详细研究基于人群的队列中带状疱疹的复发情况。
利用大型队列（45 岁及以上研究）的数据（2004-2015 年），采用生存分析方法检查首次和复发性带状疱疹的发病率。
在 17413 名首次带状疱疹发作的参与者（发病率为 9.43/1000 人年；95%置信区间，9.29-9.57）的 1846572 人年随访中，有 675 名（3.9%）经历了复发。对于年龄在 45-54 岁的人，首次和复发性带状疱疹之间的平均时间为 2 年，对于年龄在 55 岁及以上的人，平均时间为 3 年。在首次带状疱疹的患者中，复发的发病率为 11.05/1000 人年（95%置信区间，10.24-11.91），女性的复发发病率高于男性，年轻患者高于老年患者，免疫抑制患者高于非免疫抑制患者。在带状疱疹发作后 12 个月内，复发率较低，但在随后的 8 年内，复发率约为 12.00/1000 人年，保持稳定。
由于使用行政数据确定病例，可能低估了复发。非免疫抑制参与者可能存在潜在的分类错误。
我们的结果支持对已患带状疱疹的人群进行疫苗接种，并支持对这些人群的免疫原性和疫苗效力进行更多研究。
