Herpes zoster in SLE: prevalence, incidence and risk factors

Abstract

ObjectivesThis study aimed to evaluate the prevalence and incidence of herpes zoster (HZ) events and describe its associated factors in a study of patients with SLE.Methods491 consecutive SLE participants were screened for HZ events using a patient-reported questionnaire to capture outcomes on pain and other characteristics associated with HZ events. Sociodemographic, clinical and laboratory measures were also analysed, and time-dependent Cox regression survival analyses were performed to investigate factors associated with HZ events.ResultsPrevalence of HZ was 30.5%, incidence was 14.3 cases per 1000 person-years. Lymphopenia and glucocorticoid dosing were significantly associated with HZ events.ConclusionsHZ is highly prevalent in SLE, which may be linked to disease-related and treatment-related effects on cellular immunity. Our results suggest that the presence of certain risk factors may be useful to allow identification of patients at risk of HZ and improve its management in patients with SLE.

A Dermatomal Rash: Answer

“…1 Among patients with systemic lupus erythematosus (SLE), the prevalence of VZV reactivation ranges from 3.6%-30.5% in recently reported cohorts. 9,10 Given the propensity for vasculitic manifestations in patients with autoimmune conditions, such as SLE, VZV reactivation presenting with LCV and a purpuric rash or ulceration can pose a diagnostic dilemma. Ultimately, the eventual development of a dermatomal distribution to the rash, which led to diagnostic evaluation with VZV-specific NAA and immunostaining, secured the diagnosis.…”

Exploring machine learning methods for predicting systemic lupus erythematosus with herpes

“…In addition, the random forest model was the best predictor of SLE complicated with herpes, followed by traditional logistic regression, suggesting that clinicians may use the models to monitor treatment of SLE patients or disease status. Studies have found that SLE patients, especially those with active lupus nephritis who are undergoing treatment, tend to have more risk factors for herpes, including lymphocytopenia, 3 glucocorticoids, 12 leukopenia, 11 and cyclophosphamide 13 . A recombinant vaccine (Shingrix) is currently available in Spain, which has been tested in an immunosuppressed population 14 .…”

“…Elevated incidence of HZ is considered to be a result of a decline in VZV‐specific cellular immunity. Moreover, combined treatment with glucocorticoids as well as other biological agents and lymphopenia are risk factors for development of HZ in SLE patients 3 . Treatment of herpes and neuralgia affected patients’ economic burden, daily life, mood, and health‐related quality of life 4 .…”

“…Moreover, combined treatment with glucocorticoids as well as other biological agents and lymphopenia are risk factors for development of HZ in SLE patients. 3 Treatment of herpes and neuralgia affected patients' economic burden, daily life, mood, and health-related quality of life. 4 If there is a model that predicts risk of herpes in…”

Vaccine Prophylaxis of Herpes Zoster In Rheumatic Diseases: Paradigm Revision and New Opportunities

“…35,4% больных сообщили о развитии HZ в течение первых трёх лет от момента постановки диагноза СКВ, 14,6% -через 6-10 лет, 50% -более чем через 10 лет. Большинство пациентов (84,2%) никогда не получали противогерпетическую вакцинацию [11].…”