Gershon A A
Am J Med. 1984 Apr;76(4):672-7. doi: 10.1016/0002-9343(84)90293-6.
Because it is possible to identify groups of persons with a high risk of varicella development and also because it is possible to anticipate when an attack may occur, immunoprophylaxis for varicella has met with great success. In contrast, the nature of zoster--its unpredictability and low attack rate--makes immunoprophylaxis much more difficult to implement. Varicella may be modified by administration of varicella-zoster immune globulin within three days of a known exposure to the virus. Although interferon has not yet been used in an attempt to prevent or modify varicella in humans, it has been used successfully to abort an outbreak of simian varicella in a monkey colony. Thus it might be clinically useful, particularly for those who cannot be given varicella-zoster immune globulin within three days of exposure. Transfer factor has also been shown to induce at least partial immunity to varicella in children with leukemia. The duration of this protection is unknown, and further study of the efficacy of transfer factor against both varicella and possibly even against zoster seems warranted. Live attenuated varicella vaccine, although still experimental, seems now to be the most practical way to prevent severe varicella in high-risk persons. The vaccine is safe and immunogenic, even in children with underlying leukemia who are still receiving chemotherapy. Studies in Japan, Europe, and the United States have shown that most vaccinated leukemic children who are exposed are protected against severe disease, although mild breakthrough cases have been reported. Varicella vaccine's potential to cause zoster remains under study.
因为可以识别出患水痘风险高的人群组，而且还可以预测发病时间，所以水痘的免疫预防取得了巨大成功。相比之下，带状疱疹的特性——其不可预测性和低发病率——使得免疫预防更难实施。在已知接触病毒后的三天内给予水痘-带状疱疹免疫球蛋白可以减轻水痘症状。虽然干扰素尚未用于预防或减轻人类水痘，但它已成功用于阻止猴群中猴水痘的爆发。因此，它可能具有临床应用价值，特别是对于那些在接触病毒三天内无法给予水痘-带状疱疹免疫球蛋白的人。转移因子也已被证明能在白血病儿童中诱导至少部分对水痘的免疫力。这种保护的持续时间尚不清楚，似乎有必要进一步研究转移因子对水痘甚至带状疱疹的疗效。减毒活水痘疫苗虽然仍处于试验阶段，但现在似乎是预防高危人群严重水痘的最实用方法。该疫苗是安全且具有免疫原性的，即使是仍在接受化疗的潜在白血病儿童也是如此。日本、欧洲和美国的研究表明，大多数接种疫苗且接触病毒的白血病儿童受到保护，不会患上严重疾病，尽管有轻度突破性病例的报告。水痘疫苗导致带状疱疹的可能性仍在研究中。
