背景:带状疱疹(HZ;带状疱疹)是一种疼痛,由水痘带状疱疹病毒重新激活引起的皮肤病,通常在童年时期引起水痘(水痘)。HZ相当大的医疗保健负担是相对有据可查的,大约三分之一的人在他们的一生中至少经历过一次发作,使人衰弱的症状包括神经性疼痛,和并发症,如带状疱疹后神经痛,视力丧失,很少,中风,免疫受损个体的严重程度增加。然而,我们不知道对专门研究HZ复发负担的文献进行全面审查。
方法:我们进行了PubMed搜索(2003年1月1日至2023年2月2日),以评估有关发病率的现有文献,危险因素,和HZ复发的临床特征。
结果:研究报告的HZ复发发生率范围很广。在具有初始HZ发作的免疫活性或免疫活性/免疫抑制(混合)人群的一般人群中进行的研究估计,大约1.2-9.6%的个体可能会经历HZ复发。发病率为1.7-16.6例/1000人年。据报道,在有HZ的免疫受损个体中,有0.0-18.2%的HZ复发,发病率为17.0-55例/1000人年。发病率根据研究设计而变化,后续行动,研究人群。公认的HZ复发风险因素包括免疫受损状态,女性性别,家族史,和糖尿病等合并症。可能使个体容易复发的其他因素包括最初HZ发作后的长期疼痛和眼带状疱疹的存在。
结论:我们的评论强调,在最初的HZ发作之后,个体仍有HZ复发的风险,增加了人群的疾病负担。由于接种疫苗是可以预防的,国家HZ疫苗接种建议应包括有HZ病史的免疫能力和免疫功能低下个体的疫苗接种需求和时机。
带状疱疹(HZ),也被称为带状疱疹,结果来自导致儿童水痘的相同病毒。在带状疱疹中,水痘病毒重新激活,最常见的是引起疼痛的皮疹。大约三分之一的人一生中至少有一次带状疱疹。神经痛(燃烧,刺伤,有时沿神经通路的剧烈疼痛)可能会在最初的皮疹后持续数月。带状疱疹可能导致视力丧失和很少中风。免疫力低下的人带状疱疹更为严重。我们回顾了已发表的关于带状疱疹复发的信息(即,第二个,第三,或后来的带状疱疹发作),因为我们不知道对复发的信息进行了广泛的审查。我们关注的是复发率和增加复发风险的因素。总的来说,在大约十分之一的经历带状疱疹的人中,完全解决后,该疾病可能会复发。复发率根据研究的进行方式和研究中包括的患者类型而有所不同。众所周知,增加带状疱疹复发风险的因素是免疫力降低,女性性别,家族史,和其他条件(例如,糖尿病)。其他可能增加带状疱疹复发风险的因素包括带状疱疹首次发作后持续很长时间的疼痛和眼内带状疱疹,导致眼部并发症.我们的评论总结了现有数据。由于带状疱疹是可以通过疫苗预防的,预防这种疾病的策略应该包括那些有带状疱疹病史的人。
BACKGROUND: Herpes zoster (HZ; shingles) is a painful, cutaneous disease caused by reactivation of the varicella zoster virus, which causes varicella (chickenpox) typically during childhood. The considerable healthcare burden of HZ is relatively well documented, with approximately one in three individuals experiencing at least one episode during their lifetime, debilitating symptoms including neuropathic pain, and complications such as post-herpetic neuralgia, vision loss, and rarely, stroke, and increased severity in immunocompromised individuals. However, we are not aware of a comprehensive
review of literature specifically examining the burden of HZ recurrence.
METHODS: We conducted a PubMed search (1 January 2003-2 February 2023) to assess available literature on the incidence, risk factors, and clinical features of HZ recurrence.
RESULTS: The incidence of HZ recurrence reported by the studies identified was wide ranging. Studies in general populations of immunocompetent or immunocompetent/immunosuppressed (mixed) populations with an initial HZ episode estimate that approximately 1.2-9.6% of individuals may experience HZ recurrence, with an incidence rate of 1.7-16.6 cases per 1000 person-years. HZ recurrence was reported in 0.0-18.2% of immunocompromised individuals with HZ, with an incidence rate of 17.0-55 cases per 1000 person-years. Incidence rates varied according to study design, follow-up, and study populations. Recognized risk factors for HZ recurrence include immunocompromised status, female sex, family history, and comorbidities such as diabetes. Other factors that may predispose individuals to recurrence include long-lasting pain after the initial HZ episode and the presence of herpes zoster ophthalmicus.
CONCLUSIONS: Our
review underlines that following an initial HZ episode, individuals remain at risk of HZ recurrence, adding to the disease burden in a population. As HZ is preventable by vaccination, national HZ vaccination recommendations should include the need for and timing of vaccination in both immunocompetent and immunocompromised individuals who have a history of HZ.
Herpes zoster (HZ), also known as shingles, results from the same virus that causes chickenpox in childhood. In shingles, the chickenpox virus is reactivated, most commonly causing a painful skin rash. About one in three people have shingles at least once in their lifetime. Neuralgia (a burning, stabbing, and sometimes severe pain along a nerve pathway) may continue for months after the initial rash. Shingles may lead to loss of vision and rarely stroke. Shingles is more severe in people with weakened immunity. We reviewed published information on shingles recurrence (i.e., a second, third, or later episode of
shingles), as we were not aware of a broad
review of information specifically on recurrence. We focused on the rate of recurrence and factors that increase the risk of recurrence. Overall, in around one-tenth of individuals who experience shingles, the disease may reoccur after complete resolution. The rate of recurrence varied on the basis of how the studies were carried out and the type of patients included in the studies. Well-known factors that increase the risk of shingles recurrence are reduced immunity, female sex, family history, and other conditions (e.g., diabetes). Other factors that may increase the risk of shingles recurrence include pain that lasts for a long time after the first episode of shingles and having herpes zoster ophthalmicus, which leads to eye complications. Our
review summarizes available data. As shingles is preventable by vaccination, strategies to prevent this disease should include those who have a history of
shingles.