带状疱疹的流行病学和疫苗免疫策略

Epidemiology and immunization strategy of herpes zoster

带状疱疹(herpes zoster,HZ)是由潜伏的水痘-带状疱疹病毒(varicella-zoster virus,VZV)经再激活引起的,典型临床表现为躯体单侧皮疹和急性神经痛。带状疱疹后神经痛(post herpetic neuralgia,PHN)是最常见的并发症。不同国家的HZ流行特征均显示50岁及以上人群发病率上升明显,≥50岁的人群,免疫功能低下和慢性病人群都是带状疱疹HZ的高发人群。接种疫苗是预防HZ最有效的措施,2019年5月,重组带状疱疹疫苗(recombinant zoster vaccine,RZV)在中国上市,50岁及以上人群的临床试验显示,RZV安全性好,耐受性良好,可诱导机体产生较强的体液免疫和细胞免疫,保护效力可达97.2%,且接种后4年无明显下降。RZV注册上市国家均推荐50岁及以上的成人接种RZV预防HZ,我国需要制定带状疱疹疫苗的预防接种建议,并积极开展RZV在中国上市后评价研究。

Herpes zoster(HZ)is an infectious disease caused by reactivation of latent varicella zoster virus(VZV),which is characterized by a unilateral rash and acute neuralgia.Post herpetic neuralgia(PHN)is the most common complication.The prevalence of HZ in different countries showed that the incidence rate of HZ increased significantly among people aged 50 and above.People aged 50 and above,immunocompromised people and people with chronic diseases are all high-risk groups of HZ.Vaccination is the most effective measure to prevent HZ.In May 2019,recombinant herpes zoster vaccine(RZV)was approved in China.Clinical trials among people aged 50 and above showed that RZV was safe and well tolerated,and could induce better humoral and cellular immunity.The protective effect could reach 97.2%,and there was no significant decrease in 4 years after vaccination.Adults aged 50 and above are recommended to be vaccinated against HZ.China needs to formulate vaccination suggestion for herpes zoster vaccine and carry out post-marketing evaluation of RZV in China.