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The incidence of herpes zoster in patients with diabetes mellitus: A meta-analysis of cohort studies.

ABSTRACT:

Abstract

The research has correlated the risk factors of herpes zoster with some chronic diseases. This meta-analysis aimed to assess the incidence of herpes zoster in patients with diabetes mellitus.We conducted a literature search using Web of Science and PubMed for articles published from January 1, 2000 to December 31, 2019. The incidence rate ratio and 95% confidence interval for herpes zoster associated with diabetes mellitus was calculated.We included 5 cohort studies for a meta-analysis. The pooled incidences of herpes zoster in patients with diabetes mellitus and in patients without diabetes mellitus were 7.22 and 4.12 per 1000 person-years. The overall risk of developing herpes zoster was significantly higher in patients with diabetes mellitus when compared to those with no diabetes mellitus (incidence rate ratio = 1.60, 95% confidence interval = 1.33-1.93).Patients with diabetes mellitus are substantially at increased risk for the development of herpes zoster. Patients with diabetes mellitus should take into consideration the vaccination to prevent herpes zoster.

SUBMITTER: Lai SW

PROVIDER: S-EPMC8078473 | biostudies-literature | 2021 Apr

REPOSITORIES: biostudies-literature

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The incidence of herpes zoster in patients with diabetes mellitus: A meta-analysis of cohort studies.

Lai Shih-Wei SW Liu Chiu-Shong CS Kuo Yu-Hung YH Lin Cheng-Li CL Hwang Bing-Fang BF Liao Kuan-Fu KF

Medicine 20210401 16

<h4>Abstract</h4>The research has correlated the risk factors of herpes zoster with some chronic diseases. This meta-analysis aimed to assess the incidence of herpes zoster in patients with diabetes mellitus.We conducted a literature search using Web of Science and PubMed for articles published from January 1, 2000 to December 31, 2019. The incidence rate ratio and 95% confidence interval for herpes zoster associated with diabetes mellitus was calculated.We included 5 cohort studies for a meta-a ...[more]

PMID: 33879659

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Project description:IntroductionMany studies have been conducted worldwide to estimate herpes zoster (HZ) incidence rates. We synthesized studies of HZ incidence rates in the general population using meta-analysis models.MethodsA random effects meta-analysis was conducted to estimate HZ incidence from a published worldwide systematic literature review (SLR) including only individuals aged 50 years and older. Meta-regression was used to explore whether variability in incidence rates could be explained by a combination of study-specific characteristics including age, gender, continent and year of study data. The impact of adding additional covariates-case detection method (general practitioner surveillance, healthcare database, sentinel network, etc.), case definition (medical record-based, self-reported), study design (retrospective passive surveillance, retrospective active surveillance, etc.), incidence type (cumulative incidence/1000 persons or incidence rate/1000 person-years), patient type (outpatients or in- and out-patients) and latitude to the base model-was also assessed.ResultsSixty-one records from 59 studies were included in the analysis: 25, 20, 11 and 5 from Europe, North America, Asia and Oceania, respectively. There was variation in study methodology and outcomes. Heterogeneity of incidence rates was greatest among studies conducted in Asia. Meta-analysis showed that incidence increased with age, was lower in males compared to females, tended to be lower in Europe and North America compared to Asia and Oceania and increased with year of study data. The data-driven meta-regression model included continent, year of study data, gender, age and an age × gender interaction term. The difference in incidence between males and females was greater in younger ages (e.g., 50-59) compared to older age groups (e.g., 80+). None of the additional covariates contributed significantly to the model.ConclusionIncidence rates were shown to vary by age, gender, continent and year of study data.

Project description:BackgroundThe burden of herpes zoster (HZ) is significant worldwide, with millions affected and the incidence rising. Current literature has identified some risk factors for this disease; however, there is yet to be a comprehensive study that pools all evidence to provide estimates of risk. Therefore, the purpose of this study is to identify various risk factors, excluding immunosuppressive medication, that may predispose an individual to developing HZ.MethodsThe literature search was conducted in MEDLINE, EMBASE, and Cochrane Central, yielding case control, cohort, and cross-sectional studies that were pooled from January 1966 to September 2017. Search terms included the following: zoster OR herpe* OR postherpe* OR shingle* AND risk OR immunosupp* OR stress OR trauma OR gender OR ethnicity OR race OR age OR diabetes OR asthma OR chronic obstructive pulmonary disease OR diabetes. Risk ratios (RRs) for key risk factors were calculated via natural logarithms and pooled using random-effects modeling.ResultsFrom a total of 4417 identified studies, 88 were included in analysis (N = 3, 768 691 HZ cases). Immunosuppression through human immunodeficiency virus/acquired immune deficiency syndrome (RR = 3.22; 95% confidence interval [CI], 2.40-4.33) or malignancy (RR = 2.17; 95% CI, 1.86-2.53) significantly increased the risk of HZ compared with controls. Family history was also associated with a greater risk (RR = 2.48; 95% CI, 1.70-3.60), followed by physical trauma (RR = 2.01; 95% CI, 1.39-2.91) and older age (RR = 1.65; 95% CI, 1.37-1.97). A slightly smaller risk was seen those with psychological stress, females, and comorbidities such as diabetes, rheumatoid arthritis, cardiovascular diseases, renal disease, systemic lupus erythematosus, and inflammatory bowel disease compared with controls (RR range, 2.08-1.23). We found that black race had lower rates of HZ development (RR = 0.69; 95% CI, 0.56-0.85).ConclusionsThis study demonstrated a number of risk factors for development of HZ infection. However, many of these characteristics are known well in advance by the patient and clinician and may be used to guide discussions with patients for prevention by vaccination.

Dataset Information

The incidence of herpes zoster in patients with diabetes mellitus: A meta-analysis of cohort studies.

Abstract

Publications

The incidence of herpes zoster in patients with diabetes mellitus: A meta-analysis of cohort studies.

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