Increased incidence of herpes zoster among patients with systemic lupus erythematosus
Increased incidence of herpes zoster among patients with systemic lupus erythematosus
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DOI：
10.1177/0961203312470186
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发表时间：
2013-03-01
期刊：
影响因子：
2.6
通讯作者：
Wolfe, F.
中科院分区：
文献类型：
--
作者：
Chakravarty, E. F.;Michaud, K.;Wolfe, F.
带状疱疹 (HZ) 是潜伏的水痘带状疱疹病毒感染的痛苦再激活。在某些自身免疫性疾病中，带状疱疹的发病率可能会增加，包括系统性红斑狼疮 (SLE)。我们在一个前瞻性队列中检查了带状疱疹的发病率和危险因素，该队列由医生诊断为 SLE 的患者与诊断为非炎症性肌肉骨骼疾病 (MSK) 的患者进行比较。在排除入组时有带状疱疹病史的参与者后，我们对 1485 名 SLE 患者和 2775 名 MSK 患者进行了跟踪，在 2001 年至 2010 年间，每半年邮寄一次带状疱疹事件调查问卷。计算每组的年龄调整发病率，并使用 Cox 比例风险模型来确定带状疱疹的预测因素。比较各组之间的 Zostavax(R) 疫苗接种率。参与者入组时的平均年龄为 60 岁，患病时间为 13.9 年。 SLE 患者在所有年龄段都有更多的 HZ，与 MSK（8.7/1000 人年）相比，年龄调整后的发病率为 12.0/1000 人年，SLE 的风险比为 1.7（95% CI 1.08-2.71）。年龄增长和功能状态下降是带状疱疹的独立预测因素。在 SLE 中，使用泼尼松和吗替麦考酚酯会带来额外的风险。在符合年龄条件的受试者中，SLE 的带状疱疹疫苗接种率最低。狼疮 (2013) 22, 238-244。
Herpes zoster (HZ) is the painful reactivation of latent varicella zoster virus infection. The incidence of HZ may be increased in some autoimmune diseases, including systemic lupus erythematosus (SLE). We examined the incidence and risk factors for HZ in a prospective cohort of patients with physician-diagnosed SLE compared to those diagnosed with noninflammatory musculoskeletal conditions (MSK). After excluding participants with a history of prior HZ at enrollment, we followed 1485 SLE patients and 2775 MSK with semi-annual mailed questionnaires for incident HZ between 2001 and 2010. Age-adjusted incidences were calculated for each group and Cox proportional hazard models were used to identify predictors of HZ. Zostavax(R) vaccination rates were compared between groups.Participants had a mean age of 60 years at enrollment, with 13.9 years of disease. SLE patients had more HZ at all ages, with an age-adjusted incidence of 12.0/1000 person-years compared to MSK (8.7/1000 person-years) and a hazard ratio of 1.7 (95% CI 1.08-2.71) for SLE. Increasing age and reduced functional status were independent predictors of HZ. In SLE, prednisone and mycophenolate mofetil use conferred additional risk. SLE had the lowest HZ vaccination rates among age-eligible subjects. Lupus (2013) 22, 238-244.