血性疾病中的疹:发病,风险分层以及预防和免疫的新兴策略
Enrica Antonia Martino1, Ernesto Vigna1, Antonella Bruzzese1
1Haematology Unit, Department of Onco-Haematology, AO of Cosenza, Cosenza, Italy.
European journal of haematology
|October 8, 2025
概括
患有血液病的患者对疹病毒 (HZ) 的敏感度很高. 将抗病毒预防与辅助性复合性疹疫苗 (aRZV) 结合起来是预防的关键,mRNA疫苗显示出未来的希望.
科学领域:
- 免疫学 免疫学 免疫学
- 病毒学 病毒学
- 在瘤学瘤学.
背景情况:
- 由疹-疹病毒 (VZV) 再激活引起的疹 (HZ) 严重影响免疫功能低下的个体,特别是那些患有血液性恶性瘤和血液造血干细胞移植 (HSCT) 后的人.
- 这些患者面临严重HZ并发症的高风险,包括传播性疾病和后神经疼痛.
研究的目的:
- 审查血液病患者中HZ的发病,流行病学,风险因素和预防策略.
- 在这个脆弱群体中强调抗病毒预防和疫苗接种的有效性.
主要方法:
- 对最近的临床试验,观察性研究和国际指南进行批判性审查.
- 在免疫受损人群中评估HZ负担和预防性干预的有效性.
主要成果:
- 免疫抑制通过损害VZV特异性的细胞免疫力,显著增加了HZ易感性.
- 在HSCT接受者和接受特定疗法 (蛋白酶体抑制剂,JAK2抑制剂,CAR-T) 的患者中观察到高发病率 (30-60每1000人年).
- 抗病毒预防是至关重要的;辅助复合性疹疫苗 (aRZV) 显示68%-87%的疗效,即使在免疫抑制,mRNA疫苗提供未来的潜力.
结论:
- 血液病患者特别容易感染HZ.
- 有效的HZ预防需要抗病毒预防和aRZV免疫的综合方法.
- 基于mRNA的疫苗代表了在这种高风险人群中预防HZ的有希望的进步.
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