Stroke is tied to sharply increased near-term risk for herpes zoster

  • Tung YC & al.
  • PLoS ONE
  • 1 Jan 2020

  • curated by Susan London
  • Clinical Essentials
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Takeaway

  • Stroke survivors have a sharply increased risk for herpes zoster, with complications differing by stroke type.

Why this matters

  • Herpes zoster is associated with considerable pain and morbidity.
  • Episodes can be treated with pain medication and antivirals.

Key results

  • Compared with control group, survivors had elevated risk in the first year for:
    • Overall stroke: adjusted HR, 25.27 (P<.0001>
    • Hemorrhagic stroke: incident rate ratio (IRR), 2.31 (95% CI, 1.67-3.20); and
    • Ischemic stroke: IRR, 2.51 (95% CI, 2.09-3.02).
  • Risk was also elevated in first 5 years after stroke: adjusted HR, 3.44 (P<.0001>
  • In terms of complications, risk was increased for:
    • Herpes zoster ophthalmicus after hemorrhagic stroke: IRR, 12.46 (95% CI, 4.00-38.76); and
    • Postherpetic neuralgia after ischemic stroke: IRR, 2.24 (95% CI, 1.56-3.20).

Study design

  • Taiwanese nationwide retrospective case-control study using claims data for:
    • 20,551 stroke survivors, and
    • 20,551 unaffected control individuals matched for age, sex, age group, and Charlson Comorbidity Index score.
  • Main outcome: herpes zoster risk.
  • Funding: Taiwan Ministry of Science and Technology; Kaohsiung Medical University Hospital.

Limitations

  • Possible misclassification of herpes zoster diagnosis.
  • Lack of information on potential confounders such as smoking habits, alcohol intake, nutritional status.
  • Stroke severity, other features unknown.