Liver cirrhosis tied to higher risk of herpes zoster

The risk of herpes zoster (HZ) and HZ-related hospitalization is much higher among patients with liver cirrhosis (LC), especially those who are not currently recommended for HZ vaccination, than the general population, according to a nationwide population-based study in Korea.

In total, 504,986 Korean patients with LC (mean age 52.4 years, 60.8 percent men) were included in this study. The most common cause of LC was chronic hepatitis B.

The incidence rate for HZ was 21.6 per 1,000 person-years and for HZ-related hospitalization 1.81 per 1,000 person-years. The standardized incidence ratios (SIRs) were 1.09 (95 percent confidence interval [CI], 1.08‒1.09) for HZ and 1.48 (95 percent CI, 1.44‒1.52) for HZ-related hospitalization, which were higher than those in the general population.

SIRs for HZ in patients with LC aged 20‒29, 30‒39, and 40‒49 years were 1.41 (95 percent CI, 1.33‒1.48), 1.16 (95 percent CI, 1.13‒1.19), and 1.17 (95 percent CI, 1.13‒1.19), respectively.

Multivariate analysis revealed the following factors associated with an increased HZ risk among patients with LC: female sex (adjusted hazard ratio [aHR], 1.48), steroid (aHR, 1.20), immunosuppressant use (AHR, 1.26), and combined comorbidities.

HZ was defined as the presence of the International Classification of Diseases-10th revision code for HZ and concomitant prescription of antiviral medication. Study authors analysed the incidence rates and SIRs of HZ in patients with LC using data from the Health Insurance Review and Assessment Service in Korea claims database from 2009 to 2019.