Year: 2025
Type: article
Abstract: The varicella-zoster virus (VZV) is responsible for both primary varicella infection and Herpes Zoster (HZ), the latterresulting from viral reactivation in immunocompromised or elderly individuals. Patients with chronic kidneydisease (CKD) are particularly vulnerable to HZ due to an impaired immune system, compounded by chronicinflammation, uremia, and frequent use of immunosuppressive therapy in transplant recipients. HZ incidencein CKD is significantly higher than in the general population, with increased risks of complications such as postherpetic neuralgia and mortality. The recombinant zoster vaccine (RZV), a non-live subunit vaccine containingthe VZV glycoprotein E and the AS01B adjuvant system, has demonstrated a favorable safety profile in immunocompromised populations, including dialysis and kidney transplant patients. Despite the potentially reduced vaccine efficacy in patients with chronic kidney disease (CKD) due to immunosuppression, RZV has shown strong effectiveness, eliciting robust humoral and cell-mediated immune responses, and has demonstrated clinical protection in CKD populations, including both dialysis and kidney transplant recipients. In addition to preventing HZ, recent evidence indicates that zoster vaccination may reduce the incidence of cardiovascular events. This finding is particularly relevant for CKD patients, who carry an intrinsically elevated cardiovascular risk. Integrating RZV into nephrology care pathways, including on-site vaccination during dialysis sessions, may significantly improve adherence and coverage.
Institution: Ospedale Sandro Pertini
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $808
OpenAlex ID: W4410189945