The herpes zoster subunit vaccine

AL Cunningham - Expert opinion on biological therapy, 2016 - Taylor & Francis
Expert opinion on biological therapy, 2016Taylor & Francis
Introduction: Herpes zoster (HZ) causes severe pain and rash in older people and may be
complicated by prolonged pain (postherpetic neuralgia; PHN). Areas covered: HZ results
from reactivation of latent varicella-zoster virus (VZV) infection, often associated with age
related or other causes of decreased T cell immunity. A concentrated live attenuated vaccine
boosts this immunity and provides partial protection against HZ, but this decreases with age
and declines over 5-8 years. The new HZ subunit (HZ/su or Shingrix) vaccine combines a …
Abstract
Introduction: Herpes zoster (HZ) causes severe pain and rash in older people and may be complicated by prolonged pain (postherpetic neuralgia; PHN).
Areas covered: HZ results from reactivation of latent varicella-zoster virus (VZV) infection, often associated with age related or other causes of decreased T cell immunity. A concentrated live attenuated vaccine boosts this immunity and provides partial protection against HZ, but this decreases with age and declines over 5-8 years. The new HZ subunit (HZ/su or Shingrix) vaccine combines a key surface VZV glycoprotein (E) with T cell boosting adjuvant (AS01B). It is highly efficacious in protection (97%) against HZ in immunocompetent subjects, with no decline in advancing age and protection maintained for >3 years. Phase I-II trials showed safety and similar immunogenicity in severely immunocompromised patients. Local injection site pain and swelling can be severe in a minority (9.5%) but is transient (2 days).
Expert Opinion: The HZ/su vaccine appears very promising in immunocompetent patients in the ZoE-50 controlled trial. The unblinding of the current ZoE-50 trial and publication of results from the accompanying ZoE-70 trial will reveal more about its mechanism of action and its efficacy against PHN, particularly in subjects >70 years. Phase III trial results in immunocompromised patients are eagerly awaited.
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