Purpose

目的

Herpes zoster, herpes zoster vaccine, and the cost-effectiveness of the vaccine are reviewed.

旨在对带状疱疹、带状疱疹疫苗及其成本效益进行综述。

Summary

概要

Herpes zoster infection is estimated to affect one in three people during their lifetime. Two thirds of people who develop this disease are over age 60 years. Postherpetic neuralgia (PHN) is the most common complication of herpes zoster, occurring in 10–18% of patients. The associated chronic pain can be very debilitating, affecting patients’ quality of life. The pain may last for months or years and is difficult to treat, leading to increased health care costs and morbidity. To prevent herpes zoster, a live attenuated vaccine was developed and approved for marketing in 2006 for individuals age ≥60 years. The safety and efficacy of the vaccine were evaluated in the Shingles Prevention Study in 38,546 adults age ≥60 years. Compared with placebo, administration of the vaccine resulted in a 51.3% reduction in the incidence of herpes zoster and a 66.5% reduction in the incidence of PHN (p < 0.001 for both comparisons). A single dose of the vaccine is approximately $162 and is not covered by all insurance plans. Several studies evaluated the cost-effectiveness of the vaccine, which was found to be most beneficial in individuals age 70 years or older. The use of the vaccine appears to reduce health care costs and protect the public health.

估计三分之一的人会在其一生中感染带状疱疹的病毒，而三分之二的人会在60岁以后患带状疱疹。带状疱疹后神经痛（PHN）是带状疱疹最常见的并发症，出现于10–18%患者中。伴随的慢性疼痛会使患者非常虚弱，并影响其生活质量。疼痛可能会持续数月或数年且难以治疗，从而导致卫生保健费用和发病率的增加。为了预防带状疱疹，我们研制出减毒活疫苗，并且该疫苗在2006年被批准销售（适用年龄年龄≥60岁）。该疫苗的安全性和有效性的评估是通过带状疱疹预防研究项目中38,546名60岁以上的成年人进行的。与空白对照组相比，接种疫苗可使带状疱疹的发病率下降51.3%（p<0.001），PHN的发病率下降66.5%（p<0.001）。单剂量的疫苗大约是$162且并未被所有保险计划所涵盖。一些研究项目对疫苗的成本效益进行评估，发现70岁以上的老年人最受益。疫苗的使用可降低医疗成本，保护公众健康。

Conclusion

结论

The herpes zoster vaccine is effective in preventing herpes zoster and decreasing the incidence of complications. However, insurance coverage may hinder eligible patients from receiving the vaccination.

带状疱疹疫苗能有效预防带状疱疹并降低其并发症的发生率。然而，医疗保险覆盖面可能会阻碍符合条件的患者接受疫苗接种。

Adams EN et.al; American Journal Of Health-System Pharmacy; 2010 May 1; Vol. 67 (9), pp. 724-7