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. 2017 Dec;14(6):6222-6228.
doi: 10.3892/etm.2017.5297. Epub 2017 Oct 12.

Herpes zoster in patients with systemic lupus erythematosus: Clinical features, complications and risk factors

Dongying Chen  1 , Hao Li  1 , Jingyi Xie  2 , Zhongping Zhan  1 , Liuqin Liang  1 , Xiuyan Yang  1
Affiliations

Herpes zoster in patients with systemic lupus erythematosus: Clinical features, complications and risk factors

Dongying Chen et al. Exp Ther Med. 2017 Dec.

Abstract

Herpes Zoster (HZ) is reported as the most prevalent viral infection in patients with systemic lupus erythematosus (SLE). The aim of the present study was to investigate the clinical features, complications, and potential risk factors of HZ in patients with SLE from Southern China. A retrospective study was performed among patients with SLE admitted to the First Affiliated Hospital of Sun Yet-Sen University (Guangzhou, China) between 2009 and 2013. Demographic information, clinical and laboratory data, and medications used were collected and analyzed. A total of 48 instances of HZ from 46 individuals in a cohort of 1,265 SLE patients during the follow-up period were identified, with an overall prevalence of 3.6%. Complications occurred in 23.9% of patients with HZ (11/46). The risk of HZ was highest within 3-6 months following SLE diagnosis and reduced thereafter. The multivariate logistic regression analysis demonstrated that lymphopenia (OR=4.6; 95% CI=1.5-13.8; P=0.006) and treatment with high-dose glucocorticoids (GC; OR=4.3; 95% CI=1.6-11.7; P=0.004) were both significantly associated with occurrence of HZ. Lymphopenia was the only independent risk factor for the occurrence of complicated HZ (OR=15.2; 95% CI=2.7-85.1; P=0.002). There are some notable characteristics of HZ in patients with SLE in Southern China, such as the tendency to manifest in an early stage of SLE, and frequent complications with benign outcomes. The present data supported the role of lymphopenia and high-dose of GC therapy as risk factors for the occurrence of HZ. Lymphopenia was also shown to contribute to complicated HZ.

Keywords: complication; herpes zoster; lymphopenia; systemic lupus erythematosus.

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Figures

Figure 1.
Figure 1.
Time distribution of occurrence of HZ in relation to the onset of SLE. In the majority of patients (67.4%; 31/46), HZ was diagnosed within 3–6 months following SLE diagnosis, and rates reduced thereafter. HZ, herpes zoster; SLE, systemic lupus erythematosus.
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