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Meta-Analysis
. 2019 Feb 13;9(2):e022897.
doi: 10.1136/bmjopen-2018-022897.

Association between statin use and herpes zoster: systematic review and meta-analysis

Lailai Fan  1 , Yangyang Wang  2 , Xiang Liu  1 , Xueqiang Guan  3
Affiliations
Meta-Analysis

Association between statin use and herpes zoster: systematic review and meta-analysis

Lailai Fan et al. BMJ Open. .

Abstract

Objective: Statins are commonly prescribed worldwide. In addition to being potent lipid-lowering agents, statins have immunomodulating properties that may increase the risk of varicella zoster virus reactivation. This adverse effect may have substantial public health implications.

Design: We performed a meta-analysis of observational studies to assess the association between statin use and the risk of herpes zoster infection. We searched PubMed, Embase, Web of Science and Cochrane databases to identify studies published from 1980 to 2018. The multivariate-adjusted ORs were pooled using random-effect models, and subgroup and sensitivity analyses were performed to examine the source of heterogeneity.

Result: Six studies were analysed, with a total of more than two million participants. We determined if the use of statins might increase the risk of infection of herpes zoster (OR 1.18, 95% CI 1.11 to 1. 25). We detected significant heterogeneity (I2=91.2%; p<0.000), and determined that the heterogeneity arises from regional differences.

Conclusion: The use of statins may increase the risk of herpes zoster infection. Because the studies included are limited and there may be potential bias, further studies are warranted.

Keywords: herpes zoster; meta-analysis; statins.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart of the meta-analysis of association between statin use and herpes zoster.
Figure 2
Figure 2
The squares and horizontal lines correspond to the study-specific OR and 95% CIs. The area of the squares reflects the study-specific weight. Weights are from random-effect analysis. The diamond represents the pooled OR and 95% CI. ID, identity.
Figure 3
Figure 3
Circles represent identified studies.
See this image and copyright information in PMC

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