title: Increased Risk of Herpes Zoster Following Dermatomyositis and Polymyositis: A Nationwide Population-Based Cohort Study.
abstract: This study explored the possible association between dermatomyositis or polymyositis (DM or PM) and the subsequent risk of herpes zoster (HZ). We used data from the Taiwan National Health Insurance (NHI) system to address the research topic. The exposure cohort comprised 2023 patients with new diagnoses of DM or PM. Each patient was frequency matched according to age, sex, index year, and comorbidities including diabetes, renal disease, obesity, malignancy, rheumatoid arthritis, immunodeficiency virus infection, autoimmune disease not elsewhere classified, mixed connective tissue disease, or vasculitis with 4 participants from the general population who did not have a history of HZ (control cohort). Cox proportional hazards regression analysis was conducted to estimate the relationship between DM or PM and the risk of subsequent HZ. The incidence of HZ in the exposure and control cohorts was 35.8 and 7.01 per 1000 person-years, respectively. The exposure cohort had a significantly higher overall risk of subsequent HZ than did the control cohort (adjusted hazard ratio [HR] = 3.90, 95% confidence interval [CI] = 3.18-4.77). The risk of HZ in patients with DM or PM in whichever stratification (including sex, age, and comorbidity) was also higher than that of the control cohort. The findings from this population-based retrospective cohort study suggest that DM or PM is associated with an increased risk of subsequent HZ. A synergistic effect was observed between DM or PM and one of the comorbidities.
authors.affiliation: From the Department of Laboratory Medicine, Mackay Memorial Hospital, Mackay Medical College, New Taipei City, Taiwan (S-YT); Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, USA (S-YT); Management Office for Health Data, China Medical University Hospital (C-LL); College of Medicine, China Medical University, Taichung (C-LL); Department of Medicine, National Defense Medical Center, Taipei (Y-CW); Molecular and Genomic Epidemiology Center, China Medical University Hospital, China Medical University, Taichung (T-YY); Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua (T-YY); Division of Infectious Disease, Department of Medicine, Mackay Memorial Hospital (C-FK); Institute of Biomedical Engineering, National Taiwan University, Taipei (J-MC); Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung (J-SW); Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung (C-HK); and Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan (C-HK).
authors.forename: Shin-Yi
authors.initials: SY
authors.lastname: Tsai
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.forename: Ying-Chi
authors.initials: YC
authors.lastname: Wong
authors.forename: Tse-Yen
authors.initials: TY
authors.lastname: Yang
authors.forename: Chien-Feng
authors.initials: CF
authors.lastname: Kuo
authors.forename: Jiung-Mou
authors.initials: JM
authors.lastname: Cheng
authors.forename: Jyh-Seng
authors.initials: JS
authors.lastname: Wang
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003882:Dermatomyositis / Q000453:epidemiology*; D005260:Female; D006562:Herpes Zoster / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology