Section of Internal and Cardiopulmonary Medicine, University of Ferrara, Ferrara, Italy.
Section of Adult Congenital and Adult Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Via WA Mozart, 9, 37040 Legnago, Verona, Italy.
J Neurovirol. 2019 Aug;25(4):439-447. doi: 10.1007/s13365-019-00748-9. Epub 2019 May 8.
The occurrence of a cerebrovascular event after a herpes zoster (HZ) infection represents a nightmare in clinical practice, especially in those patients with concomitant cardiovascular comorbidities/risk factors and disease related per se to a higher risk of zoster infection. Moreover, the absence of a consensus opinion regarding a specific and adequate prevention of cerebrovascular events in these patients further complicates the treatment. Accumulating evidences demonstrated that HZ and HZ ophtalmicus (HZO) increase the risk of cerebrovascular events in the short-and long-term periods. Moreover, patient's ages < 40 years old, despite having fewer traditional cardiovascular comorbidities, demonstrated a higher risk of cerebrovascular events after both HZ and HZO infection. Further prospective studies are needed to analyse the role of antiviral treatments and vaccination in these subjects to clarify if they could be able to reduce the risk of stroke after a zoster infection. In the meanwhile, physicians must be aware of a higher risk of cerebrovascular events, especially in younger patients, with few cardiovascular risk factors, after an HZ infection.
带状疱疹（HZ）感染后发生脑血管事件是临床实践中的一场噩梦，尤其是在那些伴有心血管合并症/危险因素和与带状疱疹感染本身相关的更高风险疾病的患者中。此外，由于缺乏关于这些患者特定和充分的脑血管事件预防的共识意见，进一步使治疗变得复杂。越来越多的证据表明，HZ 和 HZ 眼炎（HZO）会增加短期和长期内脑血管事件的风险。此外，尽管年龄<40 岁的患者传统心血管合并症较少，但在 HZ 和 HZO 感染后发生脑血管事件的风险更高。需要进一步的前瞻性研究来分析抗病毒治疗和疫苗接种在这些患者中的作用，以明确它们是否能够降低带状疱疹感染后的中风风险。在此期间，医生必须意识到，在 HZ 感染后，具有较少心血管危险因素的年轻患者发生脑血管事件的风险更高。
