Gut Liver.
2019 May;13(3):333-341. 10.5009/gnl18304.
Increased Risk of Herpes Zoster in Young and Metabolically Healthy Patients with Inflammatory Bowel Disease: A Nationwide Population-Based Study
- Affiliations
-
- 1Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea. jooskim@snu.ac.kr
- 2Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- 3Department of Internal Medicine, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea.
- 4Department of Internal Medicine and Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
- KMID: 2448373
- DOI: http://doi.org/10.5009/gnl18304
Abstract
- BACKGROUND/AIMS
The risk of herpes zoster (HZ) among patients with inflammatory bowel disease (IBD) remains unclear in terms of age and metabolic comorbidities, including diabetes mellitus, hypertension, or dyslipidemia. We conducted a nationwide population-based study to investigate the risk of HZ in patients with IBD.
METHODS
From 2010 to 2013, a retrospective study was performed using claims data in Korea. We compared the incidence of HZ between 30,100 IBD patients (10,517 Crohn's disease [CD] and 19,583 ulcerative colitis [UC] patients) and 150,500 non-IBD controls matched by age and sex.
RESULTS
During a mean follow-up of 5.0 years, incidence rates of HZ (per 1,000 person-years) were 13.60, 14.99, and 9.19 in the CD, UC, and control groups, respectively. The risk of HZ was significantly higher in patients with CD (adjusted hazard ratio [HR], 2.13; p<0.001) and UC (adjusted HR, 1.40; p<0.001) than in the controls. The impact of CD on developing HZ was significantly more prominent in younger patients (adjusted HR, 2.61 for age <15, whereas 1.39 for age ≥60; interaction p=0.001) and in patients without metabolic comorbidities (adjusted HR, 2.24, whereas 1.59 in those with metabolic comorbidities; interaction p=0.015). Moreover, the impact of UC on developing HZ significantly increased in younger patients (adjusted HR, 2.51 in age <15, whereas 1.22 in age ≥60; interaction p=0.014) and patients without metabolic comorbidities (adjusted HR, 1.49 whereas 1.16 in those with metabolic comorbidities; interaction p<0.001).
CONCLUSIONS
IBD was associated with an increased risk of HZ, especially in younger patients without metabolic comorbidities.
