ORIGINAL ARTICLEHerpes Zoster Recurrences More Frequent Than Previously Reported
Section snippets
PATIENTS AND METHODS
We reviewed the medical records of a community population–based cohort of people with a confirmed episode of HZ followed up for recurrence for as long as 12 years after the index episode. Recurrence rates were expressed by time from the index episode to the first recurrence and stratified by sex, age, and immune status (immunocompromised or immunocompetent) as assessed at the time of the initial or index episode of HZ. Data from the Rochester Epidemiology Project22, 23 made it possible to
RESULTS
Of the 1669 adults with an index episode of HZ between January 1, 1996, and December 31, 2001, 1005 (60.2%) were women and 139 (8.3%) were immunocompromised at the time of the index HZ episode; median age was 59.4 years (mean, 59.4 years; range, 22-100 years). Additional description of the cohort has been published previously.17
For the recurrence study, the 1669 incident HZ cases were followed forward for a mean of 7.3 years (range, 1 day to 11.7 years) through December 31, 2007, looking for HZ
DISCUSSION
In a cohort of adults in Olmsted County, Minnesota, with an initial HZ episode from January 1, 1996, through December 31, 2001, the population-based recurrence rate of HZ was 6.2% after 8 years of follow-up. For many people, HZ is not a once-in-a-lifetime event, demonstrating that having HZ does not ensure protection against future HZ episodes. Indeed, after adjustment for age and sex, the rate of recurrent episodes was similar to the incidence rate of HZ episodes in the same population,17
CONCLUSION
During an average of 7 years of follow-up, HZ recurrences were as common as HZ incident occurrences in the studied population, when matching for age, sex, and immune status. Zoster vaccine is recommended for prevention of incident cases of HZ. Our high HZ recurrence rates suggest that zoster vaccination should be offered in people who have had an HZ episode to prevent potential recurrences.
REFERENCES (28)
- et al.
“Recurrent herpes zoster”: an unproved entity?
J Am Acad Dermatol
(1984) The lifetime occurrence of Herpes zoster and prevalence of post-herpetic neuralgia: a retrospective survey in an elderly population
Eur J Pain
(1999)- et al.
A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction
Mayo Clin Proc
(2007) - et al.
Herpes zoster and zosteriform herpes simplex virus infections in immunocompetent adults
Am J Med
(1986) History of the Rochester Epidemiology Project
Mayo Clin Proc
(1996)- et al.
Why do so many clinicians believe that recurrent zoster is common?
Dermatol Online J
(2007) Recurrent herpes zoster
J Dermatol
(1998)Recurrent herpes zoster revisited [letter]
Int J Dermatol
(2002)Recurrent herpes zoster
Int J Dermatol
(2001)Recurrent eruptions of herpes zoster [in Czech]
Bratisl Lek Listy (Tlacene Vyd)
(1999)
Recurrent herpes zoster with neuralgia [in German]
Forsch Komplement Med
Recurrent herpes zoster and high-dose inhaled steroids for asthma [letter]
S Afr Med J
Reactivation of herpes zoster infection by varicella-zoster virus [in Croatian]
Med Pregl
Recurrences in herpes zoster
Cutis
Cited by (0)
This work was funded by grants from Merck Research Laboratories, North Wales, PA; the National Institute of Arthritis and Musculoskeletal and Skin Diseases (AR30582); and the National Institute on Aging (AG034676).
An earlier version of this article appeared Online First.