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. 2024 Sep;30(10):1370-1373.
doi: 10.1177/13524585241260537. Epub 2024 Jun 16.

Altered lymphocyte profiles and herpes zoster infections in patients with multiple sclerosis on natalizumab

Alexandra Balshi  1 , Nova Manning  1 , John Dempsey  1 , Sachin Kumbar  1 , Ursela Baber  1 , Jacob A Sloane  1
Affiliations

Altered lymphocyte profiles and herpes zoster infections in patients with multiple sclerosis on natalizumab

Alexandra Balshi et al. Mult Scler. 2024 Sep.

Abstract

Cases of herpes zoster (HZ) in patients with MS on natalizumab (NTZ) have been documented. In this study, we assessed lymphocyte subsets in NTZ-treated patients with HZ compared to matched controls without HZ. Twenty unvaccinated patients developed HZ while on NTZ for an incidence rate of 12.3 per 1000 patient-years. These patients had lower CD8+% and higher CD4+:CD8+ ratios (p ⩽ 0.01) than non-HZ matched controls. Two patients with relapsing-remitting MS developed HZ twice while on NTZ. These findings underscore the importance of pre-NTZ HZ vaccination due to potential HZ risk.

Keywords: Disease-modifying therapies; immunology; multiple sclerosis; natalizumab.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: J.A.S. has grant funding from the National MS Society and has consulted for Biogen, Genentech, Teva, Banner, Sanofi, and Cellgene. The remaining authors have no conflicts to declare.

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