A meta-analysis of stroke risk following herpes zoster infection

BMC Infectious Diseases

Research Article

Fawziah Marra¹  Jeremy Ruckenstein¹  Kathryn Richardson² 

[1]University of British Columbia, 2405 Wesbrook Mall, V6T 1Z3, Vancouver, BC, Canada

[2]University of East Anglia, Norwich, United Kingdom

关键词: Herpes zoster;    Meta-analysis;    Stroke;    Transient ischemic attacks;    TIA;    Aging;   

DOI  :  10.1186/s12879-017-2278-z

 received in 2016-09-24, accepted in 2017-02-21,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe incidence of herpes zoster (HZ) is increasing and poses a significant health concern to aging populations. Several studies suggest an increased risk of stroke following zoster infection, but the results are conflicting. We conducted a systematic review and meta-analysis to determine if stroke risk is increased following HZ infection.MethodsA search of MEDLINE, EMBASE, Google scholar, Web of Science, CAB Direct, Cumulative Index to Nursing and Allied Health Literature, and Evidence Based Medicine Reviews was conducted for observational studies of adults with HZ infection that examined stroke and TIA risk from January 1, 1966 to May 31, 2016. Adjusted relative risks reported for similar follow-up durations were pooled across studies separately using random-effects inverse variance models.ResultsData were pooled from nine studies. Relative risk for stroke after zoster was 1.78 (95% CI 1.70–1.88) for the first month following herpes zoster, dropping progressively to 1.43 (95% CI 1.38–1.47) after 3 months, to 1.20 (95% CI 1.14–1.26) after 1 year. We found that stroke risk increases by a larger margin during the first month after a herpes zoster ophthalmicus episode: relative risk 2.05 (95% CI 1.82–2.31). The risk remains elevated one year after the acute episode.ConclusionsHerpes zoster is an established risk factor for increasing the risk of stroke, especially shortly after infection. Vaccination should be encouraged in patients at high risk of cardiovascular disease.

【 授权许可】

CC BY   
© The Author(s). 2017