Varicella zoster virus-associated disease in adult kidney transplant recipients: incidence and risk-factor analysis.
Varicella zoster virus (VZV)-related disease, particularly herpes zoster, is a complication of organ transplantation due to long-term immunosuppression. We determined the incidence and risk factors for post-transplant VZV infection by retrospectively reviewing the medical records of a cohort of 612 adult renal transplant recipients transplanted at Mayo Clinic Rochester between October 1, 2001 and October 1, 2004. Thirty-seven subjects developed herpes zoster, corresponding to a follow-up time-adjusted incidence of 11.2% at 4 years post transplant. The incidence rate of zoster was relatively constant between 6 months and 4 years, yielding an average incidence of approximately 28 per 1000 person-years. The risk of developing post-transplant zoster increased with increasing age at transplant, with each decade conferring a 1.42-fold (P=0.009) increase in risk of zoster development. Seronegativity at time of transplant conferred over 3 times the risk of development of post-transplant zoster (hazard ratio 3.4; P=0.04) compared with seropositivity. Adult kidney transplant recipients are at high risk for the development of post-transplant zoster.
Arness
T
T
Mayo Medical School, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Pedersen
R
R
Dierkhising
R
R
Kremers
W
W
Patel
R
R
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006562:Herpes Zoster / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
D007166:Immunosuppressive Agents