Clinical and immunologic features of recurrent herpes zoster (HZ)

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• 作者：Yuki Nakamura ; MD^a ; Fumi Miyagawa ; MD ; PhD^a ; Aiko Okazaki ; MD ; PhD^a ; Yoshinobu Okuno ; MD ; PhD^b ; Yasuko Mori ; MD ; PhD^c ; Hiroyasu Iso ; MD ; PhD^d ; Koichi Yamanishi ; MD ; PhD^b ; ^e ; Hideo Asada ; MD ; PhD^a ; ^{asadah@naramed-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; for the Shozu Herpes Zoster Study Group
• 关键词：cell-mediated immunity ; humoral immunity ; large-scale community-based prospective cohort study ; primary herpes zoster ; recurrent herpes zoster ; varicella-zoster virus
• 刊名：Journal of the American Academy of Dermatology
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：75
• 期：5
• 页码：950-956.e1
• 全文大小：553 K

文摘

Recurrent herpes zoster (HZ) is thought to be rare, but there have been few large-scale studies of recurrent HZ.

Objective

We conducted a large-scale prospective cohort study to characterize recurrent HZ.

Methods

We examined 12,522 participants aged 50 years or older in Shozu County and followed them up for 3 years. We compared the incidence of HZ and postherpetic neuralgia, severity of skin lesions and acute pain, cell-mediated immunity, and varicella-zoster virus–specific antibody titer between primary and recurrent HZ.

Results

A total of 401 participants developed HZ: 341 with primary HZ and 60 with recurrent HZ. Skin lesions and acute pain were significantly milder and the incidence of postherpetic neuralgia was lower in patients aged 50 to 79 years with recurrent HZ than in those with primary HZ. Varicella-zoster virus skin test induced a stronger reaction in patients aged 50 to 79 years with recurrent HZ than in those with primary HZ.

Limitations

Information on previous HZ episodes was self-reported by participants, so it could not be confirmed that they actually had a history of HZ.

Conclusion

Recurrent HZ was associated with milder clinical symptoms than primary HZ, probably because of stronger varicella-zoster virus–specific cell-mediated immunity in the patients with recurrence.