免疫功能受损的患者患带状疱疹（HZ）相关并发症的风险增加。尽管进行系统抗病毒药物和止痛药标准治疗，但常常出现并发症，包括病变的普遍性或持续性神经病理性疼痛，即所谓的带状疱疹后神经痛（PHN）。鉴于现有文献的稀缺性和对于改善患者预后的治疗选择的认识，特别是对于易受损患者群体而言，我在此处描述了一种基于早期治疗加强策略的带状疱疹病毒特异性超免疫球蛋白（VZV-IgG）治疗，该治疗在HZ辅助治疗中已获批准。 对于这个病例系列，我们选择了四例因造血系统恶性肿瘤或免疫抑制治疗导致的免疫功能障碍而患HZ的病例，这些病例表现为已有的普遍性病变和/或严重疼痛，或因PHN等复杂HZ过程而具有其他风险因素。这些病例被认为是符合病毒抑制治疗附加VZV-IgG的治疗加强策略的不同患者群体的典型案例。 所有患者对VZV-IgG和病毒抑制剂的联合治疗显示出快速反应。两名有普遍性病变的患者，在注射VZV-IgG后的第1天停止了新病变的形成。一名患有曼氏淋巴瘤的患者，在HZ诊断后9天完全愈合了病变，与类似病例或群体相比罕见。一名颈部HZ患者在注射单剂VZV-IgG后显示出良好的反应。这四例患者均没有出现带状疱疹相关并发症。这四例病例证明VZV-IgG在免疫功能受损HZ患者的辅助治疗中具有非常满意的治疗效果和耐受性，并支持早期加强HZ治疗以预防严重疾病进展的高风险患者。 © 2023. 作者。

Immunocompromised patients are at increased risk for herpes zoster (HZ)-associated complications. Despite standard therapy with systemic antiviral drugs and analgesics, complications are frequently encountered, including generalization of lesions or persistent neuropathic pain, so-called post-herpetic neuralgia (PHN). Given the scarcity of literature and awareness of therapeutic options to improve patient outcomes, especially for vulnerable patient groups, here we describe a strategy based on early intensification of treatment with a varicella zoster virus-specific hyperimmunoglobulin (VZV-IgG), which is approved in the adjuvant treatment of HZ.For this case series, we selected four cases of HZ in patients with impaired immunity due to hemato-oncologic disease or immunosuppressive treatment who presented with either existing generalized lesions and/or severe pain or with other risk factors for a complicated HZ course such as PHN. They were considered to be representative examples of different patient profiles eligible for intensification of treatment by the addition of VZV-IgG to virostatic therapy.All patients showed a rapid response to combined treatment with VZV-IgG and a virostatic agent. In two patients who had generalized lesions, the formation of new lesions ceased 1 day after VZV-IgG infusion. One patient, with mantle cell lymphoma, achieved complete healing of the lesions 9 days after diagnosis of HZ, a rare occurrence compared to similar cases or cohorts. A patient with HZ in the cervical region showed a good response after a single dose of VZV-IgG. None of the patients developed post-zoster-related complications. Combination therapy of a virostatic agent and VZV-IgG was well tolerated in these four cases.This case series demonstrates highly satisfactory treatment effectiveness and tolerability for VZV-IgG in the adjuvant treatment of immunocompromised HZ patients and supports early intensification of HZ therapy in patients at high risk of severe disease progression.© 2023. The Author(s).