Risk Factors for Herpes Zoster: A Systematic Review and Meta-analysis

Abstract

Background. Crimean-Congo hemorrhagic fever (CCHF) is a potentially fatal disease caused by a tick-borne virus from the Bunyaviridae family. Cytokines plays an important role in the pathogenesis of viral, bacterial, and immunologic diseases. This study aimed to investigate the role of TNF-alpha, IL-6, IL-10, and IFN-gamma levels in the severity of infection and clinical outcome of patients with CCHF. Methods. Patients with confirmed CCHF were divided into two groups (severe cases: Patients who exhibited hemorrhage during their hospital stay, and mild/ moderate cases: Patients who displayed no hemorrhage during their hospital stay). Demographic characteristics, laboratory tests on admission of all patients with CCHF were investigated, and serum TNF-alpha, IL-6, IL-10, and IFN-gamma levels were measured. Results. A total of 154 patients with confirmed CCHF were investigated. Fortysix (29.9%) of these patients were in the severe group. In patients with severe CCHF, significantly higher serum levels of TNF-alpha (68.2 ± 23.5; P = 0.008) and IL-6 (73.1 ± 41.6; P = 0.003) were detected, compared with cytokine levels in patients who mild/moderate CCHF (Table 1). No differences in serum IL-10 and IFN-gamma levels between patients who severe CCHF and those who mild/moderate CCHF were detected (P > 0.05). S314 • OFID 2017:4 (Suppl 1) • Poster Abstracts associated with a modest increased risk of HZ (pooled RR = 1.14; 95% CI: 1.11, 1.17). Recent physical trauma increased risk of HZ by almost twofold (pooled RR = 2.56; 95% CI: 1.97, 3.33). Conclusion. In addition to age and immunocompromised conditions, our review shows that female sex, race/ethnicity, family history, and comorbidities are risk factors for HZ. Efforts are needed to better understand risk factors and to increase the uptake of zoster vaccination.

Risk of herpes zoster in the Japanese population with immunocompromising and chronic disease conditions: Results from a claims database cohort study, from 2005 to 2014

“…Previously, for this same study population we found that IRs for HZ were higher in females compared with males and increased with greater age, and were highest in patients with IC conditions (and in particular those undergoing HSCT, subjects with HM and those with SLE), and somewhat lower in subjects with chronic medical conditions . Those findings are consistent with those from other epidemiological studies which report an increasing incidence of HZ with older age, and also a higher incidence in patients with malignancy, and other IC conditions such as SLE . In the further data we present here, we show that the influence of age and sex is also apparent in patients with different IC and chronic medical conditions.…”

“…The lifetime risk for developing HZ is estimated at 30% . Declining VZV‐specific cell‐mediated immunity, which predisposes an individual to VZV reactivation and clinical HZ, occurs as a result of age‐related “immunosenescence”, which may explain the greater risk and higher incidence of HZ in individuals aged 50 years or more . Incidence and risk is greater in women, in individuals with immunocompromised (IC) medical conditions (e.g., patients with hematological or solid tumors or those receiving immunosuppressive therapies) and also in individuals with certain chronic medical conditions .…”

“…2 Declining VZV-specific cell-mediated immunity, which predisposes an individual to VZV reactivation and clinical HZ, occurs as a result of age-related "immunosenescence", which may explain the greater risk and higher incidence of HZ in individuals aged 50 years or more. 2,6,7 Incidence and risk is greater in women, 2,6 in individuals with immunocompromised (IC) medical conditions (e.g., patients with hematological or solid tumors or those receiving immunosuppressive therapies) and also in individuals with certain chronic medical conditions. 6,[8][9][10][11][12][13][14] Older adults and those with IC conditions (where complications may be more severe) and with chronic medical conditions are also at greater risk of HZ-associated complications, most commonly postherpetic neuralgia (PHN), but also other neurological complications, ocular complications, and disseminated HZ.…”

Herpes zoster after autologous haematopoietic stem cell transplantation without antiviral prophylaxis

“…In general, patients’ age is a well‐known risk factor for HZ (Kawai & Yawn, ). Only one out of 12 patients (8·3%) without these risk factors experienced HZ following the addition of patients’ age (>56 years) to the risk factors in the present study.…”

Using natural language processing for identification of herpes zoster ophthalmicus cases to support population‐based study

“…16,22,23 P-values were calculated using chisquare test for all the categorical variables, and Wilcoxon test for all the continuous variables. Sensitivity of diagnosis codes for HZO was examined by comparing the percentage of patients with HZO codes to the percentage of HZO patients identified by NLP.…”