摘要
BACKGROUND The incidence and severity of herpes zoster and postherpetic neura lgia increase with age in association with a progressive decline in cell- media ted immunity to varicella- zoster virus (VZV). We tested the hypothesis that va ccination against VZV would decrease the incidence, severity, or both of herpes zoster and postherpetic neuralgia among older adults. METHODS We enrolled 38,546 adults 60 years of age or older in a randomized, double- blind, placebo- cont rolled trial of an investigational live attenuated Oka/Merck VZV vaccine (“ zos ter vaccine” ). Herpes zoster was diagnosed according to clinical and laborator y criteria. The pain and discomfort associated with herpes zoster were measured repeatedly for six months. The primary end point was the burden of illness due t o herpes zoster, a measure affected by the incidence, severity, and duration of the associated pain and discomfort. The secondary end point was the incidence of postherpetic neuralgia. RESULTS More than 95 percent of the subjects continued in the study to its completion, with a median of 3.12 years of surveillance for herpes zoster. A total of 957 confirmed cases of herpes zoster (315 among vaccin e recipients and 642 among placebo recipients) and 107 cases of postherpetic neu ralgia (27 among vaccine recipients and 80 among placebo recipients) were includ ed in the efficacy analysis. The use of the zoster vaccine reduced the burden of illness due to herpes zoster by 61.1 percent (P < 0.001), reduced the incidence of postherpetic neuralgia by 66.5 percent (P < 0.001), and reduced the incidenc e of herpes zoster by 51.3 percent (P < 0.001). Reactions at the injection site were more frequent among vaccine recipients but were generally mild. CONCLUSIONS The zoster vaccine markedly reduced morbidity from herpes zoster and postherpet ic neuralgia among older adults.
BACKGROUND The incidence and severity of herpes zoster and postherpetic neura lgia increase with age in association with a progressive decline in cell- media ted immunity to varicella- zoster virus (VZV). We tested the hypothesis that va ccination against VZV would decrease the incidence, severity, or both of herpes zoster and postherpetic neuralgia among older adults. METHODS We enrolled 38,546 adults 60 years of age or older in a randomized, double- blind, placebo- cont rolled trial of an investigational live attenuated Oka/Merck VZV vaccine (“ zos ter vaccine” ). Herpes zoster was diagnosed according to clinical and laborator y criteria. The pain and discomfort associated with herpes zoster were measured repeatedly for six months. The primary end point was the burden of illness due t o herpes zoster, a measure affected by the incidence, severity, and duration of the associated pain and discomfort. The secondary end point was the incidence of postherpetic neuralgia. RESULTS More than 95 percent of the subjects continued in the study to its completion, with a median of 3.12 years of surveillance for herpes zoster. A total of 957 confirmed cases of herpes zoster (315 among vaccin e recipients and 642 among placebo recipients) and 107 cases of postherpetic neu ralgia (27 among vaccine recipients and 80 among placebo recipients) were includ ed in the efficacy analysis. The use of the zoster vaccine reduced the burden of illness due to herpes zoster by 61.1 percent (P < 0.001), reduced the incidence of postherpetic neuralgia by 66.5 percent (P < 0.001), and reduced the incidenc e of herpes zoster by 51.3 percent (P < 0.001). Reactions at the injection site were more frequent among vaccine recipients but were generally mild. CONCLUSIONS The zoster vaccine markedly reduced morbidity from herpes zoster and postherpet ic neuralgia among older adults.
出处
《世界核心医学期刊文摘（神经病学分册）》
2005年第10期5-5,共1页
Digest of the World Core Medical Journals:Clinical Neurology
