Increased Risk of Herpes Zoster Infection in Patients with Celiac Disease 50 Years Old and Older.

Celiac disease Herpes zoster Immunization Shingles Vaccine

Journal

Digestive diseases and sciences
ISSN: 1573-2568
Titre abrégé: Dig Dis Sci
Pays: United States
ID NLM: 7902782

Informations de publication

Date de publication:
30 May 2024
Historique:
received: 09 11 2023
accepted: 07 05 2024
medline: 31 5 2024
pubmed: 31 5 2024
entrez: 30 5 2024
Statut: aheadofprint

Résumé

Celiac Disease (CD) is associated with increased susceptibility to certain bacterial and viral infections. Herpes zoster (HZ) is a viral infection that can be prevented by immunization. In the US, the vaccine is recommended for adults ≥ 50 or ≥ 19 with certain at-risk conditions, not including CD. We aimed to determine if adult patients aged < 50 or ≥ 50 years with CD had a higher risk of developing HZ. We designed a retrospective cohort study. CD was defined as patients with the ICD-10 code for CD and positive Celiac serology. Patients with negative serology and lacking CD ICD-10 codes served as controls. Patients who had HZ before CD diagnosis were excluded. We formed two sub-cohorts, those aged < 50 (cohort 1) and aged ≥ 50 years (cohort 2), and evaluated HZ infection at 10-year follow-up. To account for confounding variables, we performed 1:1 propensity score matching (PSM). Following PSM, cohort 1 had 6,826 CD patients, and cohort 2 had 5,337 CD patients and respective matched controls. After ten years of follow-up, in cohort 1, 62 CD patients developed HZ versus 57 controls, RR: 1.09 (CI: 0.76-1.56, p-value = 0.64). In cohort 2, 200 CD patients developed HZ versus 159 controls, RR: 1.2 (CI: 1.02-1.54, p-value = 0.03). There was no significant difference in the likelihood of getting HZ in CD patients < 50, although CD patients ≥ 50 had a modestly increased risk. Our findings do not support routine early vaccination for HZ in CD, and the vaccine should be offered at age 50.

Sections du résumé

BACKGROUND BACKGROUND
Celiac Disease (CD) is associated with increased susceptibility to certain bacterial and viral infections. Herpes zoster (HZ) is a viral infection that can be prevented by immunization. In the US, the vaccine is recommended for adults ≥ 50 or ≥ 19 with certain at-risk conditions, not including CD.
AIMS OBJECTIVE
We aimed to determine if adult patients aged < 50 or ≥ 50 years with CD had a higher risk of developing HZ.
METHODS METHODS
We designed a retrospective cohort study. CD was defined as patients with the ICD-10 code for CD and positive Celiac serology. Patients with negative serology and lacking CD ICD-10 codes served as controls. Patients who had HZ before CD diagnosis were excluded. We formed two sub-cohorts, those aged < 50 (cohort 1) and aged ≥ 50 years (cohort 2), and evaluated HZ infection at 10-year follow-up. To account for confounding variables, we performed 1:1 propensity score matching (PSM).
RESULTS RESULTS
Following PSM, cohort 1 had 6,826 CD patients, and cohort 2 had 5,337 CD patients and respective matched controls. After ten years of follow-up, in cohort 1, 62 CD patients developed HZ versus 57 controls, RR: 1.09 (CI: 0.76-1.56, p-value = 0.64). In cohort 2, 200 CD patients developed HZ versus 159 controls, RR: 1.2 (CI: 1.02-1.54, p-value = 0.03).
CONCLUSION CONCLUSIONS
There was no significant difference in the likelihood of getting HZ in CD patients < 50, although CD patients ≥ 50 had a modestly increased risk. Our findings do not support routine early vaccination for HZ in CD, and the vaccine should be offered at age 50.

Identifiants

pubmed: 38816598
doi: 10.1007/s10620-024-08487-6
pii: 10.1007/s10620-024-08487-6
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s).

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Auteurs

Arjun Chatterjee (A)

Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH, 44195, USA.

Vibhu Chittajallu (V)

Digestive Health Institute, Case Western Reserve University/University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

Andrew Ford (A)

Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH, 44195, USA.

Khaled Alsabbagh Alchirazi (KA)

Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH, 44195, USA.

Rama Nanah (R)

Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH, 44195, USA.

Emad Mansoor (E)

Digestive Health Institute, Case Western Reserve University/University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

Sarah DeLozier (S)

Clinical Research Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

Claire Jansson-Knodell (C)

Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, OH, 44195, USA.

Alberto Rubio-Tapia (A)

Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, OH, 44195, USA. RUBIOTA@ccf.org.

Classifications MeSH