Herpes zoster infection associated with acute coronary syndrome: a population-based retrospective cohort study

Lin, Cheng‐Li; Chang, Yen Jung; Wang, G.-J.; Sung, Fung Chang; Kao, Chia‐Hung

doi:10.1111/bjd.12768

Cited by 20 publications

(21 citation statements)

References 22 publications

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“…Finally, the diagnoses and codes for HZ used in our study should be as reliable as previous studies. [23–25] Second, some patients in Taiwan are highly superstitious and attempt to eliminate HZ through various religious ceremonies or folk remedies instead of seeking medical attention. Therefore, this study may have underestimated the actual incidence of HZ.…”

Section: Discussionmentioning

confidence: 99%

Herpes zoster as a risk factor for osteoporosis

Chai

Tung

et al. 2016

Medicine

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The objective of this study was to investigate the risk of osteoporosis in patients with herpes zoster (HZ) infection using a nationwide population-based dataset. The Taiwan National Health Insurance Research Database was used to compare data between 11,088 patients aged 20 to 49 years diagnosed with HZ during 1996 to 2010 and a control group of 11,088 patients without HZ. Both cohorts were followed up until the end of 2010 to measure the incidence of osteoporosis. Cox proportional-hazards regression and Kaplan–Meier analyses were used to calculate hazard ratio and cumulative incidences of osteoporosis, respectively. The overall risk of osteoporosis was 4.55 times greater in the HZ group than in the control group (2.48 vs. 0.30 per 1000 person-years, respectively) after adjusting for age, gender, Charlson Comorbidity Index, and related comorbidities. Compared with controls, patients with HZ and subsequent postherpetic neuralgia had a 4.76-fold higher likelihood of developing osteoporosis (95% confidence interval: 2.44–9.29), which was a statistically significant difference (P <0.001). Osteoporosis risk factors included female gender, age, advanced Charlson Comorbidity Index, depression, and postherpetic neuralgia. This study identified HZ is associated with an increased osteoporosis risk. Further evaluation of the value of bone mineral density test in detecting osteoporosis after HZ may be suggested. HZ vaccination could also be evaluated to lower the incidence of HZ and possibly subsequent osteoporosis. Physicians should be alerted to this association to improve early identification of osteoporosis in patients with HZ.

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Section: Discussionmentioning

confidence: 99%

Herpes zoster as a risk factor for osteoporosis

Chai

Tung

et al. 2016

Medicine

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“…The Longitudinal Health Insurance Database (LHID) contains all of the original claim data of 1,000,000 beneficiaries, randomly sampled from the beneficiaries of the NHIRD. The details of this database have been published . The identification of all patients in the LHID is encrypted, thereby protecting patient privacy.…”

Section: Methodsmentioning

confidence: 99%

Increased risk of varicella zoster virus infection in inflammatory bowel disease in an Asian population: a nationwide population-based cohort study

et al. 2014

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“…There are modestly elevated risks of acute coronary syndrome, arrhythmia and coronary artery disease following HZ [546, 547]. Herpetic infections may also be associated with atherosclerosis and thrombosis [546], with reports of HZ-associated deep vein thrombosis [548] and peripheral vascular disease [525]. Myocarditis [549] and unexplained recurrent asystole [550] following HZ have also been reported.…”

Section: Complicating Presentations and Disease Associationsmentioning

confidence: 99%

“…Emerging evidence from Taiwan and Japan suggests that patients with HZ are at increased subsequent risk of cardiovascular disease [546, 547], lymphoma [611] and other cancers [466, 612, 613], renal failure [614], SLE [615], multiple sclerosis [616], chronic fatigue syndrome [617], depression [618, 619] and erectile dysfunction [620]; however, the causality and significance of these associations remains unclear. Prevalent comorbidities such as metabolic syndrome disorders probably contribute to cardiovascular risk [547], while immunosuppression may underlie other conditions.…”

Section: Complicating Presentations and Disease Associationsmentioning

confidence: 99%

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

et al. 2017

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BackgroundHerpes zoster (HZ) is a prevalent viral disease that inflicts substantial morbidity and associated healthcare and socioeconomic burdens. Current treatments are not fully effective, especially among the most vulnerable patients. Although widely recommended, vaccination against HZ is not routine; barriers in Asia-Pacific include long-standing neglect of adult immunisation and sparse local data. To address knowledge gaps, raise awareness, and disseminate best practice, we reviewed recent data and guidelines on HZ from the Asia-Pacific region.MethodsWe searched PubMed, Scopus, and World Health Organization databases for articles about HZ published from 1994 to 2014 by authors from Australia, China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, New Zealand, the Philippines, Singapore, Taiwan, Thailand, and Vietnam. We selected articles about epidemiology, burden, complications, comorbidities, management, prevention, and recommendations/guidelines. Internet searches retrieved additional HZ immunisation guidelines.ResultsFrom 4007 retrieved articles, we screened-out 1501 duplicates and excluded 1264 extraneous articles, leaving 1242 unique articles. We found guidelines on adult immunisation from Australia, India, Indonesia, Malaysia, New Zealand, the Philippines, South Korea, and Thailand.HZ epidemiology in Asia-Pacific is similar to elsewhere; incidence rises with age and peaks at around 70 years – lifetime risk is approximately one-third. Average incidence of 3–10/1000 person-years is rising at around 5% per year. The principal risk factors are immunosenescence and immunosuppression. HZ almost always causes pain, and post-herpetic neuralgia is its most common complication. Half or more of hospitalised HZ patients have post-herpetic neuralgia, secondary infections, or inflammatory sequelae that are occasionally fatal. These disease burdens severely diminish patients’ quality of life and incur heavy healthcare utilisation.ConclusionsSeveral countries have abundant data on HZ, but others, especially in South-East Asia, very few. However, Asia-Pacific countries generally lack data on HZ vaccine safety, efficacy and cost-effectiveness. Physicians treating HZ and its complications in Asia-Pacific face familiar challenges but, with a vast aged population, Asia bears a unique and growing burden of disease. Given the strong rationale for prevention, most adult immunisation guidelines include HZ vaccine, yet it remains underused. We urge all stakeholders to give higher priority to adult immunisation in general and HZ in particular.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2198-y) contains supplementary material, which is available to authorized users.

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Herpes zoster infection associated with acute coronary syndrome: a population-based retrospective cohort study

Abstract: Herpes zoster infection is associated with an increased risk of ACS.

Cited by 20 publications

References 22 publications

Herpes zoster as a risk factor for osteoporosis

Herpes zoster as a risk factor for osteoporosis

Increased risk of varicella zoster virus infection in inflammatory bowel disease in an Asian population: a nationwide population-based cohort study

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

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