Reproductive Organ Infections and Sexually Transmitted Infections

Risk for Herpes Zoster Elevated Prior to Hematologic Cancers

Herpes zoster, or shingles, is a reactivation of a previous herpes varicella-zoster virus infection. It can be one of the earliest manifestations of HIV. A longitudinal study showed an incidence of 29.4 cases per 1000 person-years among people seropositive for HIV vs 2.0 cases per 1000 person-years among control participants who were seronegative for HIV.3 Shingles risk and severity may be increased with increasing immunosuppression.4 Because shingles has a distinctive disease course and lesions, clinical diagnosis is usually accurate, but laboratory studies may be required for confirmation.5 Patients often first experience pain along one of the sensory nerves of the skin, followed by a painful rash several days later.6 The rash begins with grouped vesicles confined to 1 dermatome or spread over 2 adjacent dermatomes. The vesicles eventually crust over and then heal 3 to 4 weeks later, but may result in significant scarring. Pain sometimes persists after resolution of the vesiculation (ie, postherpetic neuralgia).

Herpes zoster, or shingles, is a reactivation of a previous herpes varicella-zoster virus infection. It can be one of the earliest manifestations of HIV. A longitudinal study showed an incidence of 29.4 cases per 1000 person-years among people seropositive for HIV vs 2.0 cases per 1000 person-years among control participants who were seronegative for HIV.3 Shingles risk and severity may be increased with increasing immunosuppression.4

Because shingles has a distinctive disease course and lesions, clinical diagnosis is usually accurate, but laboratory studies may be required for confirmation.5 Patients often first experience pain along one of the sensory nerves of the skin, followed by a painful rash several days later.6 The rash begins with grouped vesicles confined to 1 dermatome or spread over 2 adjacent dermatomes. The vesicles eventually crust over and then heal 3 to 4 weeks later, but may result in significant scarring. Pain sometimes persists after resolution of the vesiculation (ie, postherpetic neuralgia).

The risk for herpes zoster (zoster) is elevated during the two years preceding diagnosis and during treatment of hematological cancer.

HealthDay News — The risk for herpes zoster (zoster) is elevated during the two years preceding diagnosis and during treatment of hematological cancer, according to a study published online Dec. 13 in the Journal of Infectious Diseases.

Jiahui Qian, M.P.H., from the University of New South Wales in Sydney, and colleagues conducted a prospective cohort study involving 241,497 adults (mean age, 62.0 years at recruitment in 2006 to 2009) linked to health datasets (2006 to 2015). Using time-varying proportional hazard models, the authors analyzed the relation between cancer diagnosis, treatment, and zoster risk.

There were 20,286 new cancer diagnoses and 16,350 zoster events during 1,760,481 person-years of follow-up. The researchers found that compared with those without cancer, participants with hematological and solid cancers had higher relative risks for zoster (adjusted hazard ratios, 3.47 and 1.30, respectively). Zoster risk was also elevated prior to a hematological cancer diagnosis compared with those without cancer; however, this was not the case for solid cancers. Compared with those without cancer, the risk for zoster was higher for participants with solid cancers receiving chemotherapy than for those not receiving chemotherapy (adjusted hazard ratios, 1.83 and 1.16, respectively).

“Zoster vaccination now holds promise as a preventive strategy considered for cancer patients, particularly those expected to receive chemotherapy,” the authors write.

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Two authors disclosed financial ties to the pharmaceutical industry.

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