Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Clinics (Sao Paulo). 2011;66(7):1177-82. doi: 10.1590/s1807-59322011000700009.
The goal of the present study was to estimate the risk ratio of herpes zoster among systemic lupus erythematosus patients after disease onset compared with a cohort of patients without systemic lupus erythematosus over a three-year period.
A nationwide population-based cohort study using the National Health Insurance Research Database identified 10,337 new cases of systemic lupus erythematosus as the study cohort. In addition, 62,022 patients without systemic lupus erythematosus, who were matched for age, gender, and date of systemic lupus erythematosus diagnosis, were used as the comparison cohort. These cohorts were followed-up for three years. A Cox proportional hazard regression was performed to estimate the risk ratio of herpes zoster, with adjustments for age, gender, level of insurance, urbanization level, geographic region, comorbid medical conditions, average daily dosage of corticosteroids, and the use of immune-modulation agents.
Compared to patients without systemic lupus erythematosus, the crude risk ratio and adjusted risk ratio of herpes zoster among systemic lupus erythematosus patients were 7.37 (95% confidence interval 6.75-8.04) and 2.45 (95% confidence interval 1.77-3.40), respectively. Stratified by gender, the adjusted risk ratio of herpes zoster was 2.10 (95% confidence interval 1.45-2.99) in women and 7.51 (95% confidence interval 2.89-19.52) in men. Stratified by age, the adjusted risk ratio peaked in systemic lupus erythematosus patients who were aged 18 to 24 years (risk ratio 8.78, 95% confidence interval 3.08-24.97).
Based on nationwide population-based data, there is an increased risk of herpes zoster in systemic lupus erythematosus patients compared with non-systemic lupus erythematosus patients, particularly among males and patients aged 18 to 24 years. Further research on the associated risk factors for herpes zoster in systemic lupus erythematosus patients is needed.
本研究旨在估计系统性红斑狼疮患者发病后三年内带状疱疹的风险比，与无系统性红斑狼疮的队列相比。
使用国家健康保险研究数据库进行全国性基于人群的队列研究，确定了 10337 例新的系统性红斑狼疮病例作为研究队列。此外，还选择了 62022 例无系统性红斑狼疮的患者作为匹配年龄、性别和系统性红斑狼疮诊断日期的对照组。对这些队列进行了三年的随访。使用 Cox 比例风险回归估计带状疱疹的风险比，并调整了年龄、性别、保险水平、城市化水平、地理区域、合并症、皮质类固醇的平均日剂量和免疫调节剂的使用。
与无系统性红斑狼疮的患者相比，系统性红斑狼疮患者的带状疱疹粗风险比和调整风险比分别为 7.37（95%置信区间 6.75-8.04）和 2.45（95%置信区间 1.77-3.40）。按性别分层，女性带状疱疹的调整风险比为 2.10（95%置信区间 1.45-2.99），男性为 7.51（95%置信区间 2.89-19.52）。按年龄分层，调整后的风险比在 18 至 24 岁的系统性红斑狼疮患者中最高（风险比 8.78，95%置信区间 3.08-24.97）。
基于全国性基于人群的数据，与非系统性红斑狼疮患者相比，系统性红斑狼疮患者发生带状疱疹的风险增加，特别是男性和 18 至 24 岁的患者。需要进一步研究系统性红斑狼疮患者带状疱疹的相关危险因素。
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