title: Varicella-zoster virus-specific immune responses to herpes zoster in elderly participants in a trial of a clinically effective zoster vaccine.
abstract: BACKGROUND
  The objectives of this study were to evaluate the association between varicella-zoster virus (VZV)-specific humoral and cell-mediated immunity (CMI) to herpes zoster (HZ) and protection against HZ morbidity and to compare immune responses to HZ and zoster vaccine.
  
  
  METHODS
  In 981 elderly persons who developed HZ during a zoster vaccine efficacy trial (321 vaccinees and 660 placebo recipients) and 1362 without HZ (682 vaccinees and 680 placebo recipients), CMI was measured by VZV responder cell frequency and interferon-gamma enzyme-linked immunospot, and antibodies were measured by VZV enzyme-linked immunosorbent assay against affinity-purified VZV glycoproteins (gpELISA).
  
  
  RESULTS
  Robust VZV CMI at HZ onset correlated with reduced HZ morbidity, whereas VZV gpELISA titers did not. Three weeks after HZ onset, gpELISA titers were highest in those with more severe HZ and were slightly increased in placebo recipients (compared with zoster vaccine recipients) and in older individuals. VZV CMI responses to HZ were similar in zoster vaccine and placebo recipients and were not affected by demographic characteristics or antiviral therapy, except for responder cell frequency at HZ onset, which decreased with age. When responses to zoster vaccine and HZ could be compared, VZV CMI values were similar, but antibody titers were lower.
  
  
  CONCLUSIONS
  Higher VZV CMI at HZ onset was associated with reduced HZ severity and less postherpetic neuralgia. Higher antibody titers were associated with increased HZ severity and occurrence of postherpetic neuralgia. HZ and zoster vaccine generated comparable VZV CMI.
authors.affiliation: University of Colorado Denver, Denver, CO, USA. Adriana.Weinberg@ucdenver.edu
authors.forename: Adriana
authors.initials: A
authors.lastname: Weinberg
authors.forename: Jane H
authors.initials: JH
authors.lastname: Zhang
authors.forename: Michael N
authors.initials: MN
authors.lastname: Oxman
authors.forename: Gary R
authors.initials: GR
authors.lastname: Johnson
authors.forename: Anthony R
authors.initials: AR
authors.lastname: Hayward
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Caulfield
authors.forename: Michael R
authors.initials: MR
authors.lastname: Irwin
authors.forename: James
authors.initials: J
authors.lastname: Clair
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Smith
authors.forename: Harold
authors.initials: H
authors.lastname: Stanley
authors.forename: Rocio D
authors.initials: RD
authors.lastname: Marchese
authors.forename: Ruth
authors.initials: R
authors.lastname: Harbecke
authors.forename: Heather M
authors.initials: HM
authors.lastname: Williams
authors.forename: Ivan S F
authors.initials: IS
authors.lastname: Chan
authors.forename: Robert D
authors.initials: RD
authors.lastname: Arbeit
authors.forename: Anne A
authors.initials: AA
authors.lastname: Gershon
authors.forename: Florian
authors.initials: F
authors.lastname: Schödel
authors.forename: Vicki A
authors.initials: VA
authors.lastname: Morrison
authors.forename: Carol A
authors.initials: CA
authors.lastname: Kauffman
authors.forename: Steve E
authors.initials: SE
authors.lastname: Straus
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Schmader
authors.forename: Larry E
authors.initials: LE
authors.lastname: Davis
authors.forename: Myron J
authors.initials: MJ
authors.lastname: Levin
mesh_terms: D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D006562:Herpes Zoster / Q000276:immunology / Q000517:prevention & control*; D014645:Herpesvirus 3, Human / Q000276:immunology*; D006801:Humans; D007111:Immunity, Cellular; D008297:Male; D008875:Middle Aged; D051474:Neuralgia, Postherpetic / Q000517:prevention & control; D013997:Time Factors; D014765:Viral Vaccines / Q000276:immunology*
chemical_list: D000914:Antibodies, Viral; D014765:Viral Vaccines