背景:马疱疹病毒1型(EHV-1)感染与呼吸道和神经系统疾病有关,流产,新生儿死亡。
目的:疫苗可降低EHV-1感染马临床疾病的发生。
方法:对多个数据库进行系统评价,以确定相关研究。选择标准是经过同行评审的原始研究报告,该报告调查了疫苗在体内用于预防驯养马中由EHV-1引起的疾病的情况。感兴趣的主要结果包括发热,流产,神经系统疾病,病毒血症,还有鼻腔脱落.我们评估了偏见的风险,对主要结局的发病率数据进行了探索性荟萃分析,并对每种疫苗亚型的证据质量进行了分级评估。
结果:共确定了1018项独特研究,其中35人符合纳入标准。实验研究占31/35研究,其余为观察性研究。确定了八个疫苗亚类,包括商业(改良活,灭活,混合)和实验性(修改后的,灭活,缺失突变体,DNA,重组)。偏见的风险通常是中等的,通常是因为研究方法的漏报,并且样本量很小,导致效应大小的估计不精确。一些研究报告对感兴趣的主要结果没有益处或疫苗效力最小。荟萃分析显示存在显著的异质性,我们对大多数结局的证据质量的信心是低到中等的.
结论:我们的综述表明,商业和实验性疫苗最低限度地降低了与EHV-1感染相关的临床疾病的发生率。
BACKGROUND: Equine herpes virus type 1 (EHV-1) infection in horses is associated with respiratory and neurologic disease, abortion, and neonatal death.
OBJECTIVE: Vaccines decrease the occurrence of clinical disease in EHV-1-infected horses.
METHODS: A systematic
review was performed searching multiple databases to identify relevant studies. Selection criteria were original peer-reviewed research reports that investigated the in vivo use of vaccines for the prevention of disease caused by EHV-1 in domesticated horses. Main outcomes of interest included pyrexia, abortion, neurologic disease, viremia, and nasal shedding. We evaluated risk of bias, conducted exploratory meta-analyses of incidence data for the main outcomes, and performed a GRADE evaluation of the quality of evidence for each vaccine subtype.
RESULTS: A total of 1018 unique studies were identified, of which 35 met the inclusion criteria. Experimental studies accounted for 31/35 studies, with the remainder being observational studies. Eight vaccine subclasses were identified including commercial (modified-live, inactivated, mixed) and experimental (modified-live, inactivated, deletion mutant, DNA, recombinant). Risk of bias was generally moderate, often because of underreporting of research methods, and sample sizes were small leading to imprecision in the estimate of the effect size. Several studies reported either no benefit or minimal vaccine efficacy for the primary outcomes of interest. Meta-analyses revealed significant heterogeneity was present, and our confidence in the quality of evidence for most outcomes was low to moderate.
CONCLUSIONS: Our
review indicates that commercial and experimental vaccines minimally reduce the incidence of clinical disease associated with EHV-1 infection.