Comparison of Varicella‐Zoster Virus–Specific Immunity of Patients with Diabetes Mellitus and Healthy Individuals

Abstract

Cell-mediated immunity (CMI) has been shown to be critical for the prevention and control of varicella-zoster virus (VZV)-related diseases. Because a large population-based study has revealed that diabetes mellitus is a risk factor for herpes zoster, we studied VZV-specific immune responses of patients with diabetes mellitus and compared them with those of healthy individuals. In this study, we found that patients with diabetes mellitus had significantly lower CMI to VZV than did healthy individuals. These results suggest that the increased risk for herpes zoster among patients with diabetes mellitus may be related to decreased VZV-specific CMI.

Risk factors in patients with herpes zoster infections: case-control study

“…Although we observed a higher prevalence of overall chronic disease in patients with herpes zoster (67.3%), the overall prevalence was not statistically significant in comparison to the control group (59.3%), which is in opposition to previously published data [12,21,22]. A possible explanation for this discrepancy could be the lower number of patients in our study, as compared to studies conducted in England and Wales, where more than 502,493 patients were followed over a multi-year period [12].…”

“…However, unlike hypertension, the prevalence of diabetes mellitus was significantly higher in patients with herpes zoster in comparison to the control group. An increased prevalence of diabetes mellitus in herpes zoster is in accord with the results of a study performed on 63 subjects with diabetes mellitus and 67 healthy subjects in Japan [21]. In accordance with previously published data, our data showed a statistically significant prevalence of cancer (16.4%) in patients with herpes zoster, while the prevalence of autoimmune diseases (7.3%) was not related to a higher incidence of herpes zoster [12,22].…”

“…Immunosuppression in patients with diabetes mellitus is an integral part of the disease, and thus, these patients are at high risk for the development not only of herpes zoster, but also other infections. Unlike diabetes mellitus, immunosuppression caused by treatment with chemotherapeutics in patients with autoimmune disease and cancer increases the risk of herpes zoster [1,2,5,[21][22][23].…”

“…Although it has been speculated that the socio-economic status, place of residence (urban compared to rural areas) and stress could contribute to the development of herpes zoster, the review by Thomas and Hall excluded those as potential risk factors for herpes zoster infection [12]. Altogether, the high-risk groups for the incidence of herpes zoster are patients with cancers, HIV infection, autoimmune diseases, hypertension, diabetes mellitus and some other chronic diseases [12,21,22]. Persons who are HIV-positive have a risk 12-17 times higher for the development of herpes zoster [2].…”

Prevention of herpes zoster and its complications: from the clinic to the real-life experience with the vaccine

“…Therefore, as the proportion of the elderly and fragile population is increasing, a rise in the incidence of HZ cases is expected in the near future. Besides age, comorbidities that reduce VZVspecific CMI, such as diabetes, major depression, stressful events, immunosuppressive treatments, HIV infection, lymphoma, leukaemia, bone marrow or other organ transplants and systemic lupus erythematosus, may also increase the risk of HZ (Irwin et al, 1998;Lukas et al, 2012;Okamoto et al, 2009). …”