Study Finds Increased Risk of Herpes Zoster in IBD Patients

A new study found that hospitalized patients with inflammatory bowel disease (IBD) have a greater chance of developing herpes zoster (HZ) than hospitalized patients without IBD. The study results were published in the Journal of Clinical Gastroenterology.

The Advisory Committee on Immunization Practices has recently recommended HZ vaccination for adults aged 19 years and older who are at a greater risk of developing shingles due to their disease or drug-related immunosuppression. Literature also shows that there is an increased risk of herpes zoster (HZ) in patients with inflammatory bowel disease (IBD). Hence researchers from the U.S.A conducted a study to understand the burden of HZ in IBD inpatients and contribute scientific evidence for an appropriate age cut-off vaccination recommendation.

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By using the 2014 US National Inpatient Sample (NIS), a population-based cross-sectional analysis was done to measure the frequencies and demographics of adult patients with IBD admitted to the hospital with an HZ diagnosis. Age-stratification analysis was performed, and age groups were compared with non-IBD inpatients with an HZ diagnosis.

Results:

Out of 307,260 IBD discharges, 1110 (0.35%) patients were found to have HZ as follows:

• Shingles: 63%
• Post-herpetic neuralgia: 26%
• HZ with ophthalmic involvement: 7%
• HZ with neurological involvement: 4%

Women with IBD were more likely to have shingles (P=0.002) and post-herpetic neuralgia (P=0.001) than men with IBD.

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The age distribution of shingles in IBD inpatients when compared with non-IBD patients was as follows (P=0.0004):

Thus, shingles were found to be more frequently occurring in women, and their prevalence steadily increased with aging though 32% of cases were seen in patients younger than age 50. An increased frequency of shingles was seen in hospitalized patients with IBD than in hospitalized patients without IBD.

Further reading: Guerrero Vinsard D, Wakefield D, Karagozian R, Farraye FA. Herpes Zoster in Hospitalized Patients With Inflammatory Bowel Disease: National Analysis of Disease Presentation and Age Distribution [published online ahead of print, 2022 Nov 9]. J Clin Gastroenterol. 2022;10.1097/MCG.0000000000001790. doi:10.1097/MCG.0000000000001790