Herpes zoster incidence in a multicenter cohort of solid organ transplant recipients
Article first published online: 15 JUL 2010
© 2010 John Wiley & Sons A/S
Transplant Infectious Disease
Volume 13, Issue 1, pages 15–23, February 2011
How to Cite
Pergam, S.A., Forsberg, C.W., Boeckh, M.J., Maynard, C., Limaye, A.P., Wald, A., Smith, N.L. and Young, B.A. (2011), Herpes zoster incidence in a multicenter cohort of solid organ transplant recipients. Transplant Infectious Disease, 13: 15–23. doi: 10.1111/j.1399-3062.2010.00547.x
- Issue published online: 7 FEB 2011
- Article first published online: 15 JUL 2010
- Received 5 March 2010, revised 29 May 2010, accepted for publication 3 June 2010
- herpes zoster;
- liver transplantation;
- kidney transplantation;
- African American
S.A. Pergam, C.W. Forsberg, M.J. Boeckh, C. Maynard, A.P. Limaye, A. Wald, N.L. Smith, B.A. Young. Herpes zoster incidence in a multicenter cohort of solid organ transplant recipients. Transpl Infect Dis 2011: 13: 15–23. All rights reserved
Background. Immunosuppressed patients are at increased risk for herpes zoster (HZ), but incidence in solid organ transplant (SOT) recipients has varied in multiple studies. To assess incidence of HZ, we examined patients who underwent SOT and received follow-up care within the large multicenter US Department of Veteran's Affairs healthcare system.
Methods. Incident cases of HZ were determined using ICD-9 coding from administrative databases. A multivariable Cox proportional hazards model, adjusted for a priori risk factors, was used to assess demographic factors associated with development of HZ.
Results. Among the 1077 eligible SOT recipients, the cohort-specific incidence rate of HZ was 22.2 per 1000 patient-years (95% confidence interval [CI], 18.1–27.4). African Americans (37.6 per 1000 [95% CI, 25.0–56.6]) and heart transplants recipients (40.0 per 1000 [95% CI, 23.2–68.9]) had the highest incidence of HZ. Patients transplanted between 2005 and 2007 had the lowest incidence (15.3 per 1000 [95% CI, 8.2–28.3]). In a multivariable model, African Americans (hazard ratio [HR] 1.88; 95% CI: 1.12, 3.17) and older transplant recipients (HR 1.13; 95% CI: 1.01, 1.27 [per 5-year increment]) had increased relative hazards of HZ.
Conclusions. These data demonstrate that HZ is a common infectious complication following SOT. Future studies focused on HZ prevention are needed in this high-risk population.