Incidence of herpes zoster, before and after varicella-vaccination-associated decreases in the incidence of varicella, 1992-2002
Incidence of herpes zoster, before and after varicella-vaccination-associated decreases in the incidence of varicella, 1992-2002
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DOI：
10.1086/430325
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发表时间：
2005-06-15
影响因子：
6.4
通讯作者：
Seward, JF
中科院分区：
文献类型：
--
作者：
Jumaan, AO;Yu, OC;Seward, JF
背景水痘带状疱疹病毒（VZV）引起水痘，并且在宿主的生命后期，可能重新激活以引起带状疱疹（HZ）。因为假设暴露于水痘可能会增强对潜伏VZV的免疫力，所以疫苗接种相关的水痘疾病减少导致一些人认为HZ的发病率可能会增加。我们评估了水痘疫苗接种对水痘和HZ发病率的影响。根据《国际疾病分类第九次修订版》，在住院病人和门诊病人的自动数据库中确定了HMO中水痘和HZ病例的代码。我们计算了1992 - 2002年期间水痘和HZ的发病率。随着水痘发病率的下降，HZ的发病率保持稳定。从1999年开始，水痘的经季节调整的和特定的年发病率稳步下降。年龄调整率从1995年的2.63例/1000人年下降到2002年的0.92例/1000人年;在1 - 4岁儿童中，1992 - 1996年和2002年之间下降了75%。HZ的年龄校正和特异性年发病率随时间略有波动; 1992年的年龄校正发病率最高，为4.05例/1000人年，2002年为3.71例/ 1000人年。我们的研究结果表明，水痘疫苗接种相关的减少并没有导致HZ的发病率增加。随着水痘发病率的持续下降，这些早期发现将不得不得到证实。
Background. Varicella zoster virus (VZV) causes varicella and, later in the life of the host, may reactivate to cause herpes zoster (HZ). Because it is hypothesized that exposure to varicella may boost immunity to latent VZV, the vaccination-associated decrease in varicella disease has led some to suggest that the incidence of HZ might increase. We assessed the impact that varicella vaccination has on the incidence of varicella and of HZ.Methods. Codes for cases of varicella and of HZ in an HMO were determined in automated databases of inpatients and outpatients, on the basis of the Ninth Revision of the International Classification of Diseases. We calculated the incidence, during 1992 - 2002, of varicella and of HZ.Results. The incidence of HZ remained stable as the incidence of varicella decreased. Age-adjusted and - specific annual incidence rates of varicella decreased steadily, starting with 1999. The age-adjusted rates decreased from 2.63 cases/1000 person-years during 1995 to 0.92 cases/1000 person- years during 2002; among children 1 - 4 years old, there was a 75% decrease between 1992 - 1996 and 2002. Age-adjusted and - specific annual incidence rates of HZ fluctuated slightly over time; the age-adjusted rate was highest, at 4.05 cases/1000 person-years, in 1992, and was 3.71 cases/ 1000 person- years in 2002.Conclusions. Our findings revealed that the vaccination-associated decrease in varicella disease did not result in an increase in the incidence of HZ. These early findings will have to be confirmed as the incidence of varicella disease continues to decrease.