Harnisch J P
J Am Geriatr Soc. 1984 Nov;32(11):789-93. doi: 10.1111/j.1532-5415.1984.tb06298.x.
Herpes zoster is common in the elderly. Persons over the age of 50 years have an attack rate double that of patients less than 50 years old. In the very aged, this rate nearly doubles again. The loss of cell-mediated immunity for the VZ virus appears to be the primary factor in the disruption of the dynamic containment process responsible for VZ virus latency within the sensory ganglion. Humoral immunity may play a role in the maintenance of latency, but the degree is unproven, except in the case of dissemination where loss of detectable antibodies seems to correlate with extradermatomal dissemination. Severe forms of the disease and its complications, e.g., postherpetic neuralgia, are likely among the elderly. Direct immunofluorescent staining or cytologic examination is useful for early diagnosis, and serologic changes can document the confusing clinical entity of zoster sine herpete.
带状疱疹在老年人中很常见。50岁以上的人群发病率是50岁以下患者的两倍。在高龄人群中，这一发病率几乎又会翻倍。针对水痘-带状疱疹病毒（VZ病毒）的细胞介导免疫丧失似乎是破坏负责VZ病毒在感觉神经节内潜伏的动态控制过程的主要因素。体液免疫可能在维持潜伏状态中起作用，但程度尚未得到证实，除了在播散性病例中，可检测抗体的丧失似乎与皮外播散相关。严重形式的疾病及其并发症，如带状疱疹后神经痛，在老年人中很可能出现。直接免疫荧光染色或细胞学检查有助于早期诊断，血清学变化可记录无疹性带状疱疹这一令人困惑的临床实体。
