Herpes Zoster and its prevention in Italy. Scientific consensus statement

Francesco Vitale, Michele Conversano, Paolo Bonanni, Donato Greco, Antonio Ferro, Silvestro Scotti, Marzia Lazzari Antonio Volpi, Italian Universities And Epidemiology, Marco Ercolani Stefano Valente, Elisabetta Franco, Alessandro Rossi, Stefania Maggi, Donato Greco, Francesco Vitale, Giovanni Gabutti, Giancarlo Icardi

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Abstract

[automatically translated] In this paper, an Italian group of experts presents a revision of the available data about epidemiology and prevention of herpes zoster (HZ). HZ is an acute viral diseases Caused by the reactivation of Varicella Zoster Virus (VZV). HZ is caratterizzata by neurological and dermatological symptoms with a dermatomeric localization. The reactivation of the virus from the latent status in the sensory ganglia Increases with age and failing cell mediated immunity. In Europe, blackberries than 95% of adults presents antibodies against VZV. Incidence of HZ is similar all over the world, related to the aging of the population: from 2-3 / 1000 persons / year in the age group 20 to 50 years to 5/1000 in the 60 years old, 6-7 / 1000 between 70 and 80 up to> 1/100 in older than 80. in Italy, about 157,000 new cases of HZ are estimated every year with an incidence of 6. 3/1000 persons / year mostly in older adults. Among the hospitalized cases, 60% are over 65 years of age. The blackberries frequent and severe complication of HZ is post herpetic neuralgia (PHN), caratterizzata by severe localized pain lasting at least 3 month after the beginning of the acute phase. The pain is responsible for a sharp decrease in the quality of life. In Europe, PHN is described in 2.6-27% of HZ cases. In Italy, given Obtained by a network of General Practitioner show PHN in 20.6% of HZ patients, while 9.2% of the patients still presents PHN at 6 months. The blackberries frequent localization is thoracic; When the virus reactivate at the level of the ophthalmic division of the trigeminal nerve most patients develop ocular complications. The clinical and therapeutical managements of HZ patients is difficult and the results are poor Often. Prevention of HZ and PHN in the population over 50 years is possible using a live attenuated vaccine containing VZV (Oka / Merck strain, not less than 19,400 plaque forming units), available since 2006. Efficacy of anti-HZ vaccine was Demonstrated in two large clinical trials That Showed a 51% reduction in the incidence of HZ and a 61% decrease of the burden of illness. Incidence of PHN Showed a reduction of 67% in immunized subjects. Long-term follow-up Showed in persistence of the protection even if a decrease was Noted in older subjects and with time. Effectiveness studies confirm the date of clinical trials and Numerous Pharmaco-economical evaluation show a favorable profile of HZ vaccine. The vaccine is recommended in the USA, Canada and some European countries for people over 60.
Original languageItalian
Pages (from-to)111-127
Number of pages17
JournalIGIENE E SANITÀ PUBBLICA
Volume70
Publication statusPublished - 2014

All Science Journal Classification (ASJC) codes

  • General Medicine

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