Abstract
Varicella-zoster virus (VZV) causes varicella as a primary infection and remains latent in the ganglia until it becomes reactivated to cause herpes zoster. Individuals with varicella develop adaptive humoral and cell-mediated immunity. Compromised cell-mediated immunity is thought to contribute to the development of herpes zoster. Recent evidence suggests that changes in the epidemiology of varicella have affected the epidemiology of herpes zoster. The incidence of herpes zoster is higher in older adults; thus, the herpes zoster vaccine is recommended for older adults. However, the incidence of herpes zoster is expected to rise among younger individuals; hence, vaccination with the varicella vaccine should also be considered in younger adults. In order to determine the need for vaccination in different populations, it is important to establish methods to accurately assess the activity of cell-mediated immunity and humoral immunity.
Highlights
The first varicella vaccine was developed in Japan in 1974 by Takahashi et al [1] and was subsequently approved for use in high-risk children in Europe in 1984
Vaccination has dramatically changed the epidemiology of varicella in countries with routine immunization programs
Commercial assays are recommended to evaluate the level of disease-induced immunity; they are not recommended to evaluate the level of vaccine-induced immunity because of their low sensitivity [2,44]
Summary
The first varicella vaccine was developed in Japan in 1974 by Takahashi et al [1] and was subsequently approved for use in high-risk children in Europe in 1984. Varicella vaccines have subsequently become part of routine immunization programs in several countries. Vaccination has dramatically changed the epidemiology of varicella in countries with routine immunization programs. In Japan, routine immunization for varicella has been shown to affect the epidemiology of herpes zoster [3]. Latent VZV is reactivated to cause herpes zoster. The role of humoral immunity in VZV infection has been well-described, as antibodies are known to be involved in the development of varicella. Little is known about the role of cell-mediated immunity (CMI) against VZV, which is thought to play an important role in the development of herpes zoster [7].
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