title: Family history and herpes zoster risk in the era of shingles vaccination.
abstract: BACKGROUND
  Herpes zoster is a common mucocutaneous infection caused by reactivation of latent varicella zoster virus previously introduced during a varicella infection. The epidemiology of the disease has changed since the approval of Zostavax(®) and the risk factors have been studied in depth.
  
  
  OBJECTIVE
  To further assess the possibility of family history as a risk factor for herpes zoster, determine the age of herpes zoster onset and the rate of recurrence.
  
  
  METHODS
  A case-control study involved 1103 acute herpes zoster patients and 523 controls.
  
  
  RESULTS
  Case patients were more likely to report blood relatives with a history of herpes zoster than controls (43.5% vs. 10.5%; P<0.001) (odds ratio for first-degree relatives, 4.44; 95% confidence interval 3.11-6.35). A dose-dependent effect was documented; risk was increased with multiple blood relatives (odds ratio, 17.15; 95% confidence interval, 7.50-39.18) compared with single blood relatives (odds ratio, 5.24; 95% confidence interval, 3.79-7.23). The mean age of herpes zoster onset was 51.7 (SD 19.0) years and the recurrence rate was 9.3%.
  
  
  CONCLUSIONS
  The results indicate a stronger association between herpes zoster and family history of herpes zoster than previously reported in the literature and suggest a genetic predisposition to herpes zoster may be more frequently inherited along maternal lines. A lower mean age of herpes zoster onset than previously documented in the literature is reported, which has implications for vaccine timing.
authors.affiliation: University of Texas School of Medicine at San Antonio, San Antonio, TX, USA. hernandezp3@livemail.uthscsa.edu
authors.forename: Paul O
authors.initials: PO
authors.lastname: Hernandez
authors.forename: Saba
authors.initials: S
authors.lastname: Javed
authors.forename: Natalia
authors.initials: N
authors.lastname: Mendoza
authors.forename: Whitney
authors.initials: W
authors.lastname: Lapolla
authors.forename: Lindsey D
authors.initials: LD
authors.lastname: Hicks
authors.forename: Stephen K
authors.initials: SK
authors.lastname: Tyring
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005192:Family Health; D005260:Female; D006562:Herpes Zoster / Q000453:epidemiology* / Q000517:prevention & control; D053061:Herpes Zoster Vaccine / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D018570:Risk Assessment; D014611:Vaccination / Q000379:methods; D055815:Young Adult
chemical_list: D053061:Herpes Zoster Vaccine