Family history and herpes zoster risk in the era of shingles vaccination.

Hernandez PO, Javed S, Mendoza N, Lapolla W, Hicks LD, Tyring SK.

Source

University of Texas School of Medicine at San Antonio, San Antonio, TX, United States.

Abstract

BACKGROUND:

Herpes zoster is a common mucocutaneous infection caused by reactivation of latent varicella zoster virus previously introduced during a varicella infection. The epidemiology of the disease has changed since the approval of Zostavax(®) and the risk factors have been studied in depth.

OBJECTIVES:

To further assess the possibility of family history as a risk factor for herpes zoster, determine the age of herpes zoster onset and the rate of recurrence.

STUDY DESIGN:

A case-control study involved 1103 acute herpes zoster patients and 523 controls.

RESULTS:

Case patients were more likely to report blood relatives with a history of herpes zoster than controls (43.5% vs. 10.5%; P<0.001) (odds ratio for first-degree relatives, 4.44; 95% confidence interval 3.11-6.35). A dose-dependent effect was documented; risk was increased with multiple blood relatives (odds ratio, 17.15; 95% confidence interval, 7.50-39.18) compared with single blood relatives (odds ratio, 5.24; 95% confidence interval, 3.79-7.23). The mean age of herpes zoster onset was 51.7 (SD 19.0) years and the recurrence rate was 9.3%.

CONCLUSIONS:

The results indicate a stronger association between herpes zoster and family history of herpes zoster than previously reported in the literature and suggest a genetic predisposition to herpes zoster may be more frequently inherited along maternal lines. A lower mean age of herpes zoster onset than previously documented in the literature is reported, which has implications for vaccine timing.
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