Increased risk of chronic fatigue syndrome following herpes zoster: a population-based study

Tsai, Shin‐Yi; Yang, Tien-Shuh; Chen, Hung‐Jen; Chen, Ching-Shiun; Lin, Wei-Che; Kuo, Chien-Feng; Kao, Chia Hung

doi:10.1007/s10096-014-2095-x

Cited by 27 publications

(25 citation statements)

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“…Numerous studies have suggested a potential role for HHV‐6 and/or EBV as triggers for ME/CFS and limited studies have suggested the involvement of VZV in ME/CFS . Conversely, there has only been a single study on GWI patients and herpesviruses suggesting that there was reactivation of multiple herpesviruses (HHV‐6, EBV, and VZV) in these patients .…”

Section: Discussionmentioning

confidence: 99%

Myalgic encephalomyelitis/chronic fatigue syndrome and gulf war illness patients exhibit increased humoral responses to the herpesviruses‐encoded dUTPase: Implications in disease pathophysiology

Halpin

Williams

Klimas

et al. 2017

Journal of Medical Virology

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Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Gulf War Illness (GWI) are debilitating diseases with overlapping symptomology and there are currently no validated tests for definitive diagnosis of either syndrome. While there is evidence supporting the premise that some herpesviruses may act as possible triggers of ME/CFS, the involvement of herpesviruses in the pathophysiology of GWI has not been studied in spite of a higher prevalence of ME/CFS in these patients. We have previously demonstrated that the deoxyuridine triphosphate nucleotidohydrolases (dUTPase) encoded by Epstein-Barr virus (EBV), human herpesvirus-6 (HHV-6), and varicella-zoster virus (VZV) possess novel functions in innate and adaptive immunity. The results of this study demonstrate that a significant percentage of patients with ME/CFS (30.91–52.7%) and GWI (29.34%) are simultaneously producing antibodies against multiple human herpesviruses-encoded dUTPases and/or the human dUTPase when compared to controls (17.21%). GWI patients exhibited significantly higher levels of antibodies to the HHV-6 and human dUTPases than controls (p = 0.0053 and p = 0.0036, respectively), while the ME/CFS cohort had higher anti-EBV-dUTPase antibodies than in both GWI patients (p = 0.0008) and controls (p < 0.0001) as well as significantly higher anti-human dUTPase antibodies than in controls (p = 0.0241). These results suggest that screening of patients’ sera for the presence of various combinations of anti-dUTPase antibodies could be used as potential biomarkers to help identify/distinguish patients with these syndromes and better direct treatment.

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Section: Discussionmentioning

confidence: 99%

Myalgic encephalomyelitis/chronic fatigue syndrome and gulf war illness patients exhibit increased humoral responses to the herpesviruses‐encoded dUTPase: Implications in disease pathophysiology

Halpin

Williams

Klimas

et al. 2017

Journal of Medical Virology

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“…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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“…However, explicit psychiatric diagnoses, mood, and anxiety disorders have rarely been examined, except for depression, with HZ reported to be an independent risk factor for major depression and depressive disorders in a large prospective study [18]. In general, the relative effects of these risk factors for HZ onset decreased with increasing age [13].Interestingly, recent studies have reported that chronic cytomegalovirus (CMV) infection may stimulate increasing HZ virus reactivation with age [19], and that there is a significant increase in chronic fatigue after HZ, with incidence increasing over time [20]. It is impossible not to pose the critical question of whether chronic activation of inflammatory pathways plays a role in the pathogenesis of frailty [21].…”

mentioning

confidence: 99%

“…Interestingly, recent studies have reported that chronic cytomegalovirus (CMV) infection may stimulate increasing HZ virus reactivation with age [19], and that there is a significant increase in chronic fatigue after HZ, with incidence increasing over time [20]. It is impossible not to pose the critical question of whether chronic activation of inflammatory pathways plays a role in the pathogenesis of frailty [21].…”

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confidence: 99%

Herpes zoster vaccine: a shot to maintain wellbeing

Michel¹

2015

Aging Clin Exp Res

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The current era is full of contradictory vaccine issues. The emerging Ebola pandemic stimulates the world's citizens who are calling for the urgent development of vaccine to prevent the disease [1]. They seem to be suddenly remembering that vaccines represent a major advancement in public health [2]. While the complete eradication of polio, neonatal tetanus, congenital rubella, and measles are still the main targets in less developed countries [3], inhabitants of high-resource countries are focusing on rare adverse effects of vaccines to discredit the efficacy and effectiveness of vaccination. As a result, there is an increase in vaccine-preventable diseases in both children and adults. Indeed, it has been estimated that ten times more adults (40 to 50 thousand) die than children in the USA annually from potentially vaccine-preventable diseases [4].In this controversial context, alongside vaccines for lifethreatening diseases, there have emerged new vaccines to prevent the occurrence of diseases and their complications. Herpes zoster (HZ) vaccine [5][6][7], is the best example of such quality improvement vaccines. In this issue, Stefania Maggi and collaborators present a comprehensive and upto-date review of how the HZ vaccine improves healthy ageing [8]. This paper raises some questions concerning the global epidemiology of the disease, improved knowledge of HZ risk factors, the well-known and more surprising consequences of the disease, as well as the increasing dilemma about age and the new indications for the currently available vaccine.The incidence rate (IR) of HZ in Italy, at 6.3 per thousand person-years [8,9], is higher than the mean incidence rate of 3-5 per thousand person-years reported in an analysis of 130 studies conducted in 26 countries in North America, Europe, and Asia-Pacific [10]. This could be related to a temporal increase in the incidence of HZ, often occurring before the introduction of varicella vaccination programmes [11], as in Finland [11] and Germany [12]. In the United Kingdom, one study reported that the median age at HZ diagnosis was 62 years (interquartile range 48-73) [13]. The IR was more or less stable between the ages of 10 and 44 years (at around 2.4 per thousand personyears), but increased more than threefold, to reach 15 in the 80-84 year old age group [12]. In the same study population, the IR was 36 % higher in females than in males [12]. Prodromic pain was experienced by 69.5 % of South Korean patients, of whom 95.1 % had moderate-to-severe pain [14]. In Italy, postherpetic neuralgia (PHN) occurred in 20.6 and 9.2 % of HZ patients older than 50 years after 3 and 6 months respectively [8,15], which corresponds to the mean 6-month PHN risk reported in the world literature [16].The risk factors for HZ have recently been better identified, and Maggi's paper describes them in detail [8]. However, it is important to insist on a few of these factors. In a study cohort of 144,959 adults diagnosed with herpes zoster between 2000 and 2011, severely immunosuppressive conditions r...

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Increased risk of chronic fatigue syndrome following herpes zoster: a population-based study

Cited by 27 publications

References 26 publications

Myalgic encephalomyelitis/chronic fatigue syndrome and gulf war illness patients exhibit increased humoral responses to the herpesviruses‐encoded dUTPase: Implications in disease pathophysiology

Myalgic encephalomyelitis/chronic fatigue syndrome and gulf war illness patients exhibit increased humoral responses to the herpesviruses‐encoded dUTPase: Implications in disease pathophysiology

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

Herpes zoster vaccine: a shot to maintain wellbeing

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