滅活水痘疫苗減少造血細胞移植者帶狀況疹的發病率

重建CD4 T細胞對水痘帶狀況疹病毒的免疫

  2002年7月5日─在造血細胞移植前30天和移植後30、60、90分別接種滅活水痘疫苗能夠減少帶狀況疹發病率從30%到13%。這項研究結果發表在7月4日的《The New England Journal of Medicine》雜誌上。

  「水痘帶狀況疹病毒從潛伏期引發導致帶狀況疹的發生,這種疾病經常發生在造血細胞移植者中。」來自加利福尼亞的斯坦福大學醫學院的Atsuko Hata和他的合作者寫道:「在造血細胞移植前和移植後90天之內接種滅活的水痘疫苗能夠減少帶狀況疹的發生危險。」

  研究中119位病人中111進行了造血細胞移植術。53位接種疫苗的有7人發生了皰疹而58位沒有接種的有9位發生了帶狀況疹。剔除2位在移植術前就發生了皰疹的病人,接種疫苗的發生產疹率為13%而未接種的為30%(P=0.02)。

  在體外進行CD4T細胞對水痘-帶狀況疹病毒增殖實驗,接種疫苗的病人的平均刺激指數比未接種的高。刺激指數每增高一個單位病人發生帶狀況疹風險就降低1.6以上。刺激指數大於5.0的病人帶狀況疹保護率大於93%。

  「這種保護與CD4T細胞對水痘帶狀況疹病毒的免疫重建相關。」作者寫道。「在移植前後接種疫苗對病人預防皰疹病毒感染特別有效,因為潛伏病毒的亞臨床啟動能夠進一步刺激抗病毒免疫能力。」

  Merck & Co.資助這項研究。

Inactivated Varicella Vaccine Reduces Zoster in Hematopoietic Cell Recipients

Restores CD4 T-Cell Immunity Against Varicella-Zoster Virus

By Laurie Barclay, MD
WebMD Medical News

Reviewed by Gary D. Vogin, MD

July 5, 2002 -- Inactivated varicella vaccine given 30 days before and 30, 60 and 90 days after hematopoietic cell transplantation significantly reduced the occurrence of zoster from 30% to 13%, according to results of a randomized trial reported in the July 4 issue of The New England Journal of Medicine.

"The reactivation of varicella-zoster virus from latency causes zoster and is common among recipients of hematopoeitic-cell transplants," write Atsuko Hata, MD, and colleagues from Stanford University School of Medicine in California. "Inactivated varicella vaccine given before hematopoietic cell transplantation and during the first 90 days thereafter reduces the risk of zoster."

Of 119 patients enrolled in the study, 111 received a transplant. Zoster developed in seven of 53 vaccinated patients and in 19 of 58 unvaccinated patients. After excluding two patients who developed zoster before transplantation, rates of zoster activation were 13% in vaccinated patients and 30% in unvaccinated patients (p=0.02).

In vitro CD4 T-cell proliferation in response to varicella-zoster virus, expressed as the mean stimulation index, was greater in vaccinated than in unvaccinated patients. Risk of zoster decreased with each unit of increase in the stimulation index above 1.6. Patients with a stimulation index greater than 5.0 had greater than 93% protection against zoster.

"The protection correlates with reconstitution of CD4 T-cell immunity against varicella-zoster virus," the authors write. "A regimen of vaccination both before and after transplantation might be particularly effective for patients with herpesvirus infections, because antiviral immunity may be stimulated further by subclinical reactivation of the latent virus."

Merck & Co. has provided research support to the senior author on this study.

© 2002 WebMD Inc. All rights reserved.

    
相關報導
孩童的帶狀疱疹比預期更常見
2015/3/3 下午 02:46:00
父母親拒絕水痘疫苗增加了未接種孩童的風險
2010/1/15 下午 02:25:00
MMRV治療使用規範更新
2008/3/24 下午 01:53:00

上一頁
   1   2   3  




回上一頁