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The Short- and Long-Term Risk of Stroke after Herpes Zoster - A Nationwide Population-Based Cohort Study

BACKGROUND AND OBJECTIVE: Varicella zoster virus (VZV) is known to cause VZV vasculopathy, which may be associated with stroke. A recent study found an increased risk of stroke within one year of herpes zoster. We aimed to investigate the short and long-term effects of herpes zoster on the risk of s...

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Autores principales: Sreenivasan, Nandini, Basit, Saima, Wohlfahrt, Jan, Pasternak, Björn, Munch, Tina N., Nielsen, Lars P., Melbye, Mads
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3714240/
https://www.ncbi.nlm.nih.gov/pubmed/23874897
http://dx.doi.org/10.1371/journal.pone.0069156
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author Sreenivasan, Nandini
Basit, Saima
Wohlfahrt, Jan
Pasternak, Björn
Munch, Tina N.
Nielsen, Lars P.
Melbye, Mads
author_facet Sreenivasan, Nandini
Basit, Saima
Wohlfahrt, Jan
Pasternak, Björn
Munch, Tina N.
Nielsen, Lars P.
Melbye, Mads
author_sort Sreenivasan, Nandini
collection PubMed
description BACKGROUND AND OBJECTIVE: Varicella zoster virus (VZV) is known to cause VZV vasculopathy, which may be associated with stroke. A recent study found an increased risk of stroke within one year of herpes zoster. We aimed to investigate the short and long-term effects of herpes zoster on the risk of stroke. METHODS: Using Danish national registers, we constructed a cohort consisting of all Danish adults ≥18 years old between 1995 and 2008 (n = 4.6 million; person-years of follow-up = 52.9 million). Individual-level information on prescriptions for herpes zoster antiviral treatment and diagnoses of stroke was obtained from national registers. We compared the risk of stroke in persons who had received the specific dosage of acyclovir for herpes zoster with persons who had never received antiviral treatment by Poisson regression. RESULTS: During follow-up, 2.5% received treatment for herpes zoster and 5.0% were diagnosed with stroke. Individuals who had received medication had a 127% (95% CI 83–182%) increased risk the first two weeks, 17% (CI 9–24%) between two weeks and one year, and 5% (2–9%) after the first year. The increased risk was greatest in the youngest age group (<40). To control for healthcare-seeking behaviour, we conducted parallel analyses investigating the risk of selected fractures after herpes zoster and found no similar increased risks. CONCLUSIONS: This large nationwide cohort study found an increased risk of stroke after treatment for herpes zoster. Although the short-term risk was particularly high, we cannot rule out the possibility of a small but important long-term risk.
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spelling pubmed-37142402013-07-19 The Short- and Long-Term Risk of Stroke after Herpes Zoster - A Nationwide Population-Based Cohort Study Sreenivasan, Nandini Basit, Saima Wohlfahrt, Jan Pasternak, Björn Munch, Tina N. Nielsen, Lars P. Melbye, Mads PLoS One Research Article BACKGROUND AND OBJECTIVE: Varicella zoster virus (VZV) is known to cause VZV vasculopathy, which may be associated with stroke. A recent study found an increased risk of stroke within one year of herpes zoster. We aimed to investigate the short and long-term effects of herpes zoster on the risk of stroke. METHODS: Using Danish national registers, we constructed a cohort consisting of all Danish adults ≥18 years old between 1995 and 2008 (n = 4.6 million; person-years of follow-up = 52.9 million). Individual-level information on prescriptions for herpes zoster antiviral treatment and diagnoses of stroke was obtained from national registers. We compared the risk of stroke in persons who had received the specific dosage of acyclovir for herpes zoster with persons who had never received antiviral treatment by Poisson regression. RESULTS: During follow-up, 2.5% received treatment for herpes zoster and 5.0% were diagnosed with stroke. Individuals who had received medication had a 127% (95% CI 83–182%) increased risk the first two weeks, 17% (CI 9–24%) between two weeks and one year, and 5% (2–9%) after the first year. The increased risk was greatest in the youngest age group (<40). To control for healthcare-seeking behaviour, we conducted parallel analyses investigating the risk of selected fractures after herpes zoster and found no similar increased risks. CONCLUSIONS: This large nationwide cohort study found an increased risk of stroke after treatment for herpes zoster. Although the short-term risk was particularly high, we cannot rule out the possibility of a small but important long-term risk. Public Library of Science 2013-07-17 /pmc/articles/PMC3714240/ /pubmed/23874897 http://dx.doi.org/10.1371/journal.pone.0069156 Text en © 2013 Sreenivasan et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Sreenivasan, Nandini
Basit, Saima
Wohlfahrt, Jan
Pasternak, Björn
Munch, Tina N.
Nielsen, Lars P.
Melbye, Mads
The Short- and Long-Term Risk of Stroke after Herpes Zoster - A Nationwide Population-Based Cohort Study
title The Short- and Long-Term Risk of Stroke after Herpes Zoster - A Nationwide Population-Based Cohort Study
title_full The Short- and Long-Term Risk of Stroke after Herpes Zoster - A Nationwide Population-Based Cohort Study
title_fullStr The Short- and Long-Term Risk of Stroke after Herpes Zoster - A Nationwide Population-Based Cohort Study
title_full_unstemmed The Short- and Long-Term Risk of Stroke after Herpes Zoster - A Nationwide Population-Based Cohort Study
title_short The Short- and Long-Term Risk of Stroke after Herpes Zoster - A Nationwide Population-Based Cohort Study
title_sort short- and long-term risk of stroke after herpes zoster - a nationwide population-based cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3714240/
https://www.ncbi.nlm.nih.gov/pubmed/23874897
http://dx.doi.org/10.1371/journal.pone.0069156
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