Increased risk of cardiovascular events in patients with herpes zoster: A population‐based study

Wu, Po-Yuan; Lin, Cheng‐Li; Sung, Fung‐Chang; Chou, Tzu-Chieh; Lee, Yuan‐Teh

doi:10.1002/jmv.23892

Cited by 19 publications

(19 citation statements)

References 22 publications

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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].…”

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%

“…Prevalent comorbidities such as metabolic syndrome disorders probably contribute to cardiovascular risk [547], while immunosuppression may underlie other conditions. Like HZ, kidney disease [160, 335], cancer [466, 612, 621, 622], and depression [158] are also associated with immunosuppression, and HZ may occur coincidentally either before or after these conditions manifest.…”

Section: Complicating Presentations and Disease Associationsmentioning

confidence: 99%

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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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Section: Complicating Presentations and Disease Associationsmentioning

confidence: 99%

Section: Complicating Presentations and Disease Associationsmentioning

confidence: 99%

Section: Complicating Presentations and Disease Associationsmentioning

confidence: 99%

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

et al. 2017

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“…Notably, the risk of HZ attacks is significantly increased in patients with CAD when compared with age-matched controls, with comorbid diabetes mellitus (DM) adding additional risk (15,16). Likewise, within 2 years of HZ diagnosis, the risk of cardiovascular events is clearly elevated (17). Traditionally, CAD and the underlying atherosclerosis have been recognized as vaso-degenerative conditions caused by the subendothelial deposition of lipids, which then elicit a maladaptive repair process (18).…”

Section: Introductionmentioning

confidence: 99%

Pyruvate controls the checkpoint inhibitor PD-L1 and suppresses T cell immunity

Watanabe

Shirai

Namkoong

et al. 2017

Journal of Clinical Investigation

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“…Among those infections, herpes zoster (HZ) reactivation (from varicella zoster virus [VZV]) is an important category because HZ episodes are associated with the subsequent development of post-herpetic neuralgia (PHN) and long-term elevated risks for cardiovascular and stroke events1213. Indeed, recent studies discovered that CKD as well as ESRD patients have 60% and nearly 200% higher risks of developing HZ compared with age/gender-matched population, respectively1415.…”

mentioning

confidence: 99%

Serum vitamin D levels are positively associated with varicella zoster immunity in chronic dialysis patients

Chao

Lee

Yang

et al. 2014

Sci Rep

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Uremia results in a relatively immunocompromised status, and patients under chronic dialysis have an elevated risk of developing herpes zoster (HZ). We sought to investigate the relationship between vitamin D status and immunity to varicella-zoster virus (VZV). A multicenter prevalent hemodialysis cohort was assembled between 2012 and 2013. We assayed the biochemical parameters, 25-hydroxy- (25-OH-D) and 1,25-dihydroxyvitamin D, vitamin D-binding protein levels in the sera. VZV immunity was quantitated using VZV-specific glycoprotein IgG and IgM titers. Eighty-eight patients were enrolled and their sera were analyzed. Chronic hemodialysis patients with 25-OH-D < 30 ng/ml (insufficiency or deficiency) had significantly lower VZV-IgG than those with sufficient 25-OH-D (p = 0.04). This discrepancy became more prominent if active vitamin D users alone were analyzed (p = 0.01). Generalized additive modeling showed that those with 25-OH-D higher than 27.8 ng/ml or bioavailable 25-OH-D higher than 3.88 ng/ml had significantly higher VZV-IgG levels than those with lower values. Linear regression suggested that both total and bioavailable 25-OH-D were significantly associated with higher VZV-IgG levels (p = 0.003 [total] and 0.01 [bioavailable]), whereas patients with cancer had lower VZV-IgG. Vitamin D may therefore be a potentially useful choice for raising VZV immunity in chronic dialysis patients.

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Increased risk of cardiovascular events in patients with herpes zoster: A population‐based study

Cited by 19 publications

References 22 publications

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

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

Pyruvate controls the checkpoint inhibitor PD-L1 and suppresses T cell immunity

Serum vitamin D levels are positively associated with varicella zoster immunity in chronic dialysis patients

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