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. 2011 Dec;39(6):537-44.
doi: 10.1007/s15010-011-0162-0. Epub 2011 Jul 29.

Risk of Herpes zoster in patients with underlying diseases: a retrospective hospital-based cohort study

A Hata  1 , M Kuniyoshi, Y Ohkusa
Affiliations

Risk of Herpes zoster in patients with underlying diseases: a retrospective hospital-based cohort study

A Hata et al. Infection. 2011 Dec.

Abstract

Purpose: To determine the incidence of Herpes zoster in patients with one of 17 specific underlying diseases compared with that in patients with other underlying diseases.

Methods: We conducted a retrospective hospital-based cohort study using data from patients' electronic medical records for the period 2001-2007 of the Kitano Hospital Research Database. These analyses included 55,492 patients with one of 17 underlying diseases, which were those reported as related to the contraction of Herpes zoster. Of these, 769 patients contracted Herpes zoster. The main outcome measure was the clinical diagnosis of Herpes zoster.

Results: The adjusted hazard ratios (95% confidence interval) for Herpes zoster in patients with the 17 diseases were compared with other patients, with the following results: brain tumor [3.84 (2.51-5.88)], lung cancer [2.28 (1.61-3.22)], breast cancer [2.41 (1.52-3.82)], esophageal cancer [4.19 (2.16-8.11)], gastric cancer [1.95 (1.39-2.72)], colorectal cancer [1.85 (1.33-2.56)], gynecologic cancer [3.45 (2.08-5.70)], malignant lymphoma [8.23 (6.53-10.38)], systemic lupus erythematosus [3.90 (2.66-5.70)], rheumatoid arthritis [2.00 (1.60-2.50)], diabetes mellitus [2.44 (2.10-2.85)], hypertension [2.04 (1.75-2.38)], renal failure [2.14 (1.65-2.79)], and disk hernia [2.18 (1.52-3.13)].

Conclusions: Patients with diabetes mellitus, renal failure, and malignancies have a 1.8-8.4-fold higher risk of a Herpes zoster event than patients with other diseases. Future studies should investigate alteration of the immune system in the underlying diseases and approaches for Herpes zoster prevention.

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Figures

Fig. 1
Fig. 1
Patients with depression showed no significantly lower event-free survival rate than the cohort without the disease (17). Patients with one of the other 16 underlying diseases showed significantly lower event-free survival rate than the cohort without the index disease (1–16). Kaplan–Meier plots of Herpes zoster event-free survival over 6 years of follow-up after the time of the first diagnosis of underlying disease in 2001–2007 at the Kitano Hospital Tazuke Kofukai Medical Research Institute. The x-axis shows age. The y-axis shows probability. p-values are derived using the log-rank test
Fig. 1
Fig. 1
Patients with depression showed no significantly lower event-free survival rate than the cohort without the disease (17). Patients with one of the other 16 underlying diseases showed significantly lower event-free survival rate than the cohort without the index disease (1–16). Kaplan–Meier plots of Herpes zoster event-free survival over 6 years of follow-up after the time of the first diagnosis of underlying disease in 2001–2007 at the Kitano Hospital Tazuke Kofukai Medical Research Institute. The x-axis shows age. The y-axis shows probability. p-values are derived using the log-rank test
See this image and copyright information in PMC

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