Incidence of complications of herpes zoster in individuals on immunosuppressive therapy: A register-based population study - 08/04/22
, Ana-Maria Vilcu b, Cindy Etienne c, d, Flora Finet c, d, Thierry Blanchon b, Cecile Souty b, Thomas Hanslik b, c, d, ⁎ Highlights |
• | Complications of herpes zoster are over three times more frequent in individuals exposed to immunosuppressive therapy. |
• | Exposed individuals showed more persistent postherpetic neuralgia. |
• | Complicated zoster occurred after a median of one year of immunosuppressants. |
Abstract |
Objectives |
Herpes zoster (HZ) exposes to alterations of the quality-of-life. HZ is more frequent in immunocompromised individuals, but whether immunosuppression is associated with a higher rate of complications is not well documented. We aimed to assess association between drug-induced immunosuppression and HZ complications.
Methods |
Data from a sample of the French healthcare claims from 01/01/2006 to 12/31/2018 were analyzed. Complicated zoster (CZ) was defined as a hospitalization with a code for HZ or the first-time dispensation of high-dose valacyclovir and specific neuralgia analgesics. Drug-induced immunosuppression was identified through medication dispensation. Risk ratios were calculated to compare incidences in exposed individuals (EI) and non-exposed to immunosuppressive therapy (NEI).
Results |
We identified 227 and 2838 CZ, accounting for an incidence of 178 per 100,000 person-year (95%CI[154.9–201.1]) and 51.7 per 100,000 person-year (95%CI[49.8–53.6]), in EI and NEI, respectively (risk ratio: 3.44 (95%CI[3.01–3.94]). Mean age was 66 years in both groups. CZ occurred after a median of 11.7 months (IQR[5.3–49.9]) of immunosuppressive therapy. Post-herpetic neuralgia (PHN) lasted at least 3 months in 32.6% and 22.5% of cases in EI and NEI, respectively (p=.01).
Conclusions |
Drug-induced immunosuppression increases the risk of CZ and exposes to longer-lasting PHN. Figures provided in this study could help guide prophylaxis of HZ.
Le texte complet de cet article est disponible en PDF.Keywords : Herpes zoster, Postherpetic neuralgia, Immunosuppression, Valacyclovir, Corticosteroid
Plan
Vol 84 - N° 4
P. 531-536 - avril 2022 Retour au numéro
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