The short- and long-term risk of stroke after herpes zoster - a nationwide population-based cohort study.

<h4>Background and objective</h4>Varicella zoster virus (VZV) is known to cause VZV vasculopathy, which may be associated with stroke. A recent study found an increased risk of stroke within one year of herpes zoster. We aimed to investigate the short and long-term effects of herpes zost...

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Autores principales:	Nandini Sreenivasan, Saima Basit, Jan Wohlfahrt, Björn Pasternak, Tina N Munch, Lars P Nielsen, Mads Melbye
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/28d1d2e003f94ed493253b7f7c0e5e3f
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spelling	oai:doaj.org-article:28d1d2e003f94ed493253b7f7c0e5e3f2021-11-18T07:37:22ZThe short- and long-term risk of stroke after herpes zoster - a nationwide population-based cohort study.1932-620310.1371/journal.pone.0069156https://doaj.org/article/28d1d2e003f94ed493253b7f7c0e5e3f2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23874897/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background and objective</h4>Varicella zoster virus (VZV) is known to cause VZV vasculopathy, which may be associated with stroke. A recent study found an increased risk of stroke within one year of herpes zoster. We aimed to investigate the short and long-term effects of herpes zoster on the risk of stroke.<h4>Methods</h4>Using Danish national registers, we constructed a cohort consisting of all Danish adults ≥18 years old between 1995 and 2008 (n = 4.6 million; person-years of follow-up = 52.9 million). Individual-level information on prescriptions for herpes zoster antiviral treatment and diagnoses of stroke was obtained from national registers. We compared the risk of stroke in persons who had received the specific dosage of acyclovir for herpes zoster with persons who had never received antiviral treatment by Poisson regression.<h4>Results</h4>During follow-up, 2.5% received treatment for herpes zoster and 5.0% were diagnosed with stroke. Individuals who had received medication had a 127% (95% CI 83-182%) increased risk the first two weeks, 17% (CI 9-24%) between two weeks and one year, and 5% (2-9%) after the first year. The increased risk was greatest in the youngest age group (<40). To control for healthcare-seeking behaviour, we conducted parallel analyses investigating the risk of selected fractures after herpes zoster and found no similar increased risks.<h4>Conclusions</h4>This large nationwide cohort study found an increased risk of stroke after treatment for herpes zoster. Although the short-term risk was particularly high, we cannot rule out the possibility of a small but important long-term risk.Nandini SreenivasanSaima BasitJan WohlfahrtBjörn PasternakTina N MunchLars P NielsenMads MelbyePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 7, p e69156 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Nandini Sreenivasan Saima Basit Jan Wohlfahrt Björn Pasternak Tina N Munch Lars P Nielsen Mads Melbye The short- and long-term risk of stroke after herpes zoster - a nationwide population-based cohort study.
description	<h4>Background and objective</h4>Varicella zoster virus (VZV) is known to cause VZV vasculopathy, which may be associated with stroke. A recent study found an increased risk of stroke within one year of herpes zoster. We aimed to investigate the short and long-term effects of herpes zoster on the risk of stroke.<h4>Methods</h4>Using Danish national registers, we constructed a cohort consisting of all Danish adults ≥18 years old between 1995 and 2008 (n = 4.6 million; person-years of follow-up = 52.9 million). Individual-level information on prescriptions for herpes zoster antiviral treatment and diagnoses of stroke was obtained from national registers. We compared the risk of stroke in persons who had received the specific dosage of acyclovir for herpes zoster with persons who had never received antiviral treatment by Poisson regression.<h4>Results</h4>During follow-up, 2.5% received treatment for herpes zoster and 5.0% were diagnosed with stroke. Individuals who had received medication had a 127% (95% CI 83-182%) increased risk the first two weeks, 17% (CI 9-24%) between two weeks and one year, and 5% (2-9%) after the first year. The increased risk was greatest in the youngest age group (<40). To control for healthcare-seeking behaviour, we conducted parallel analyses investigating the risk of selected fractures after herpes zoster and found no similar increased risks.<h4>Conclusions</h4>This large nationwide cohort study found an increased risk of stroke after treatment for herpes zoster. Although the short-term risk was particularly high, we cannot rule out the possibility of a small but important long-term risk.
format	article
author	Nandini Sreenivasan Saima Basit Jan Wohlfahrt Björn Pasternak Tina N Munch Lars P Nielsen Mads Melbye
author_facet	Nandini Sreenivasan Saima Basit Jan Wohlfahrt Björn Pasternak Tina N Munch Lars P Nielsen Mads Melbye
author_sort	Nandini Sreenivasan
title	The short- and long-term risk of stroke after herpes zoster - a nationwide population-based cohort study.
title_short	The short- and long-term risk of stroke after herpes zoster - a nationwide population-based cohort study.
title_full	The short- and long-term risk of stroke after herpes zoster - a nationwide population-based cohort study.
title_fullStr	The short- and long-term risk of stroke after herpes zoster - a nationwide population-based cohort study.
title_full_unstemmed	The short- and long-term risk of stroke after herpes zoster - a nationwide population-based cohort study.
title_sort	short- and long-term risk of stroke after herpes zoster - a nationwide population-based cohort study.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/28d1d2e003f94ed493253b7f7c0e5e3f
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The short- and long-term risk of stroke after herpes zoster - a nationwide population-based cohort study.

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