No increased risk of herpes zoster found in cirrhotic patients: a nationwide population-based study in Taiwan.
BACKGROUND
The association between liver cirrhosis (LC) and herpes zoster has rarely been studied. We investigated the hypothesis that LC, known as an immunodeficiency disease, may increase the risk of herpes zoster using a national health insurance database in Taiwan.


METHODS
The study cohort included cirrhotic patients between 1998 and 2005 (n = 4667), and a ratio of 1:5 randomly sampled age- and gender-matched control patients (n = 23,335). All subjects were followed up for 5 years from the date of cohort entry to identify whether or not they had developed herpes zoster. Cox proportional-hazard regressions were performed to evaluate 5-year herpes zoster-free survival rates.


RESULTS
Of all patients, 523 patients developed herpes zoster during the 5-year follow-up period, among whom 82 were LC patients and 441 were in the comparison cohort. The adjusted hazard ratio (AHR) of herpes zoster in patients with LC was not higher (AHR: 0.77, 95% confidence interval: 0.59-1.01, p = 0.06) than that of the controls during the 5-year follow-up. No increased risk of herpes zoster was found in LC patients after stratification by age, gender, urbanization level, income, geographic region, and all comorbidities.


CONCLUSIONS
This large nationwide population-based cohort study suggests that there is no increased risk for herpes zoster among people who have LC compared to a matching population.
Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Ping-Hsun
PH
Wu
Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Yi-Ting
YT
Lin
Department of Pharmacy, Taipei Medical University-Wanfang Hospital, Taipei, Taiwan; Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan.
Chun-Nan
CN
Kuo
Department of Pharmacy, Taipei Medical University-Wanfang Hospital, Taipei, Taiwan; Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan.
Wei-Chiao
WC
Chang
Department of Healthcare Management, Yuanpei University, Hsinchu, Taiwan.
Wei-Pin
WP
Chang
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006562:Herpes Zoster / Q000453:epidemiology*; D014645:Herpesvirus 3, Human; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012306:Risk; D018570:Risk Assessment; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult