Stroke risk increases after herpes zoster in patients with autoimmune disease

Patients with an autoimmune disease may have an increased risk of stroke after a herpes zoster infection.
Patients with an autoimmune disease may have an increased risk of stroke after a herpes zoster infection.

(HealthDay News) — For patients with autoimmune diseases, the risk of stroke is increased in the few months subsequent to incident herpes zoster (HZ), according to a study published in Arthritis & Rheumatology.

Leonard H. Calabrese, DO, from the Cleveland Clinic, and colleagues identified patients with autoimmune disease using Medicare data from January 1, 2006, through December 31, 2013. The authors examined whether the incidence of hospitalized stroke was increased immediately following HZ compared with incidence at later time points.

 

The researchers found that the crude incidence of stroke varied from 2.30 per 100 patient-years (95% confidence interval [CI], 0.96 to 5.52) within 90 days of HZ in patients who had HZ-related cranial nerve complications and did not receive treatment, to 0.87 per 100 patient-years (95% CI, 0.75 to 1.02) at 366 to 730 days for those who did not have complications and who received treatment. The overall incidence rate ratio (IRR) was 1.36 (95% CI, 1.10 to 1.68) for stroke in the first 90 days vs at 366 to 730 days after HZ, after multivariable adjustment for multiple stroke-related factors. Patients with zoster and cranial nerve complications had greater risk (IRR, 2.08; 95% CI, 0.99 to 4.36). The incidence of subsequent stroke was lower with prompt antiviral therapy (IRR, 0.83; 95% CI, 0.70 to 0.98).

"These data underscore the urgency of developing strategies for reducing the risk of varicella-zoster virus," the authors write.

Reference

  1. Calabrese LH, Xie F, Yun H, et al. Herpes zoster and the risk of stroke in patients with autoimmune diseases. Arthrit Rheum. 2017. doi:10.1001/art.39855
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