title: Hospitalization for Varicella and Zoster in Children with Inflammatory Bowel Disease.
abstract: OBJECTIVE
  To evaluate the association between inflammatory bowel disease (IBD) and varicella- and herpes zoster-related pediatric hospitalizations.
  
  
  METHODS
  We performed a cross-sectional inpatient study using the triennial Healthcare Cost and Utilization Project Kids' Inpatient Database for years 1997-2012 to evaluate the association between a secondary diagnosis of IBD and a primary diagnosis of varicella or herpes zoster for hospitalized children ages 5-20 years. Billing codes were used to identify varicella, herpes zoster, ulcerative colitis, Crohn's disease, and other immunocompromising conditions. A logistic regression model was fitted to quantify the odds of varicella or zoster between these categories.
  
  
  RESULTS
  There were 8 828 712 weighted admissions meeting the study criteria, 4434 with varicella and 4488 with herpes zoster. There was an association of IBD and immunocompromising conditions with hospitalization for varicella and herpes zoster. This association was stronger among children with Crohn's disease (varicella OR, 12.75; 95% CI, 8.30-19.59; zoster OR, 7.91; 95% CI, 5.60-11.18) compared with children with ulcerative colitis (varicella OR 4.25; 95% CI 1.98-9.12, zoster OR 3.90; 95% CI 1.98-7.67).
  
  
  CONCLUSIONS
  IBD in children is associated with hospitalizations for varicella and herpes zoster. These results highlight the importance of efforts to vaccinate patients with IBD without varicella immunity, ideally before the initiation of immunosuppressive therapy. Furthermore, research is needed on the safety and efficacy of the varicella vaccine in children with IBD on immunomodulators or biologic therapy.
authors.affiliation: Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD. Electronic address: daniel.adams@usuhs.edu.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Adams
authors.affiliation: Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD.
authors.forename: Cade M
authors.initials: CM
authors.lastname: Nylund
mesh_terms: D000293:Adolescent; D002644:Chickenpox / Q000150:complications* / Q000628:therapy; D019433:Chickenpox Vaccine; D002648:Child; D002673:Child, Hospitalized; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006562:Herpes Zoster / Q000150:complications* / Q000628:therapy; D014645:Herpesvirus 3, Human; D006760:Hospitalization; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000628:therapy; D007297:Inpatients; D008297:Male; D010343:Patient Admission; D012044:Regression Analysis; D055815:Young Adult
chemical_list: D019433:Chickenpox Vaccine; D007166:Immunosuppressive Agents