title: Increased risk of herpes zoster in children with cancer: A nationwide population-based cohort study.
abstract: Herpes zoster is rare in healthy children, but immunocompromised persons have an increased risk of herpes zoster and severe diseases. Considering the very limited information on herpes zoster in children with cancer, we performed a nationwide population-based cohort study to estimate the incidence of herpes zoster in children with cancer and to explore the association between the 2 diseases.Data were obtained from the National Health Research Institutes Database in Taiwan. A total of 4432 children with newly diagnosed cancer between 2000 and 2007 were identified as the cancer cohort, and 17,653 children without cancer frequency-matched by sex and age at entry were considered the noncancer cohort. The association between herpes zoster and childhood cancer was determined.Children with cancer had a higher risk of herpes zoster. The incidence rate of herpes zoster was higher in the cancer cohort than in the noncancer cohort (20.7 vs 2.4 per 10,000 person-years; IRR = 8.6; 95% CI = 4.8-15.6). The cumulative incidence was significantly higher in the cancer cohort (P < 0.0001). Leukemia, lymphoma, and solid tumor were all associated with the increased risk, and leukemia had the highest magnitude of strength of association.This nationwide population-based cohort study demonstrated that children with cancer were associated with an increased risk of herpes zoster. In addition to early antiviral treatment, vaccination with heat-treated zoster vaccine or adjuvanted subunit vaccine could be an appropriate policy to decrease the incidence in children with cancer.
authors.affiliation: School of Medicine, College of Medicine Division of Infectious Diseases, Children's Hospital Division of Pediatric Hematology-Oncology, Children's Hospital Graduate Institute of Biostatistics, College of Management School of Post-Baccalaureate Chinese Medicine School of Chinese Medicine Department of Pediatrics, Chung Shan Medical University Hospital School of Medicine, Chung Shan Medical University Department of Biotechnology and Bioinformatics Department of Healthcare Administration, College of Health Science Management Office for Health Data Department of Medical Research Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Hsiao-Chuan
authors.initials: HC
authors.lastname: Lin
authors.forename: Yu-Hua
authors.initials: YH
authors.lastname: Chao
authors.forename: Kang-Hsi
authors.initials: KH
authors.lastname: Wu
authors.forename: Ting-Yu
authors.initials: TY
authors.lastname: Yen
authors.forename: Yu-Lung
authors.initials: YL
authors.lastname: Hsu
authors.forename: Tsung-Hsueh
authors.initials: TH
authors.lastname: Hsieh
authors.forename: Hsiu-Mei
authors.initials: HM
authors.lastname: Wei
authors.forename: Jhong-Lin
authors.initials: JL
authors.lastname: Wu
authors.forename: Chih-Hsin
authors.initials: CH
authors.lastname: Muo
authors.forename: Kao-Pin
authors.initials: KP
authors.lastname: Hwang
authors.forename: Ching-Tien
authors.initials: CT
authors.lastname: Peng
authors.forename: Cheng-Chieh
authors.initials: CC
authors.lastname: Lin
authors.forename: Tsai-Chung
authors.initials: TC
authors.lastname: Li
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006562:Herpes Zoster / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009369:Neoplasms / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology