Kim Dong Hyun, Kang Sang-Bum
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.
Korean J Intern Med. 2025 May;40(3):347-356. doi: 10.3904/kjim.2024.342. Epub 2025 Apr 30.
Patients with inflammatory bowel disease (IBD) are at increased risk of herpes zoster (HZ), particularly those receiving immunosuppressive treatments such as corticosteroids, thiopurines, and biologics, which elevate the likelihood of varicella-zoster virus reactivation. Despite this, vaccination rates among patients with IBD remain low. Shingrix, a recombinant zoster vaccine, is generally preferred because of its high efficacy (> 90%) and safety profile in immunocompromised individuals, unlike the live attenuated zoster vaccine (Zostavax). This review underscores the importance of HZ vaccination for patients aged ≥ 50 years, as well as for younger patients receiving high-risk therapies such as JAK inhibitors. Tailored vaccination strategies based on individual risk factors, including disease severity, medication use, and ethnicity, may enhance prevention. Given the higher incidence of HZ in certain populations, such as those in Korea, vaccination recommendations should be adapted accordingly. Further research is needed to evaluate the long-term effectiveness of Shingrix in younger patients with IBD to ensure sustained protection and prevent complications, such as postherpetic neuralgia.
炎症性肠病（IBD）患者患带状疱疹（HZ）的风险增加，尤其是那些接受免疫抑制治疗的患者，如使用皮质类固醇、硫唑嘌呤和生物制剂，这些治疗会增加水痘-带状疱疹病毒再激活的可能性。尽管如此，IBD患者的疫苗接种率仍然很低。重组带状疱疹疫苗Shingrix通常更受青睐，因为它在免疫功能低下的个体中具有高效（>90%）和安全性，这与减毒活带状疱疹疫苗（Zostavax）不同。本综述强调了HZ疫苗接种对于≥50岁患者以及接受JAK抑制剂等高风险治疗的年轻患者的重要性。基于个体风险因素（包括疾病严重程度、药物使用和种族）制定的个性化疫苗接种策略可能会加强预防效果。鉴于在某些人群（如韩国人群）中HZ的发病率较高，疫苗接种建议应相应调整。需要进一步研究来评估Shingrix在年轻IBD患者中的长期有效性，以确保持续的保护并预防并发症，如带状疱疹后神经痛。
