Herpes zoster after liver transplantation: incidence, risk factors, and complications.
Herpes zoster is the consequence of the reactivation of latent varicella-zoster infection. Immunosuppression may be a predisposing factor for herpes zoster. We have retrospectively assessed the risk of herpes zoster, the risk factors for its occurrence, and its evolution in a population of 209 consecutive liver transplant recipients. Herpes zoster developed in 25 (12%) of patients. One-, 3-, 5-, and 10-year actuarial rates of herpes zoster were 3%, 10%, 14%, and 18%, respectively. In a case-control study, patients developing herpes zoster were younger, received a higher number of immunosuppressive drugs, and were more frequently receiving mycophenolate mofetil or azathioprine. In multivariate analysis, the only factor related to herpes zoster occurrence was treatment with mycophenolate mofetil or azathioprine. Eight patients (31%) developed postherpetic neuralgia. In conclusion, herpes zoster is a relatively common complication after liver transplantation. It is related to immunosuppressive therapy. Postherpetic neuralgia develops in one third of patients with posttransplant herpes zoster.
Herrero
J Ignacio
JI
Liver Unit, Clinica Universitaria de Navarra, Pamplona, Spain. iherrero@unav.es
Quiroga
Jorge
J
Sangro
Bruno
B
Pardo
Fernando
F
Rotellar
Fernando
F
Alvarez-Cienfuegos
Javier
J
Prieto
Jesus
J
D005260:Female; D006562:Herpes Zoster / Q000453:epidemiology / Q000276:immunology*; D014645:Herpesvirus 3, Human / Q000502:physiology*; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000601:surgery / Q000821:virology; D008104:Liver Cirrhosis, Alcoholic / Q000601:surgery; D016031:Liver Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000821:virology*; D012189:Retrospective Studies; D012307:Risk Factors; D014775:Virus Activation