Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Am J Gastroenterol. 2023 Sep 1;118(9):1592-1600. doi: 10.14309/ajg.0000000000002209. Epub 2023 Feb 3.
Limited data are available regarding the association between liver cirrhosis (LC) and the risk of herpes zoster (HZ). This study aimed to determine the risk of HZ in patients with LC.
HZ was defined as the presence of the International Classification of Diseases-10th revision code for HZ and concomitant prescription of antiviral medication. The incidence rates and standardized incidence ratios (SIRs) of HZ in patients with LC were analyzed using data from the Health Insurance Review and Assessment Service in Korea claims database from 2009 to 2019.
A total of 504,986 Korean patients with LC were included. The mean age was 52.4 years, and 60.8% were men. Chronic hepatitis B was the most common cause of LC. The incidence rates for HZ and HZ-related hospitalization were 21.6 of 1,000 and 1.81 of 1,000 person-years, respectively. The SIRs for HZ and HZ-related hospitalization were 1.09 (95% confidence interval [CI]: 1.08-1.09) and 1.48 (95% CI: 1.44-1.52), respectively, which were significantly higher than those in the general population. Patients with LC aged 20-29, 30-39, and 40-49 years had SIRs for HZ of 1.41 (95% CI: 1.33-1.48), 1.16 (1.13-1.19), and 1.17 (1.13-1.19), respectively. In multivariable analysis, woman (adjusted hazard ratio [AHR]: 1.48), steroid (AHR: 1.20), immunosuppressant use (AHR: 1.26), and combined comorbidities were associated with an increased risk of HZ among patients with LC.
Patients with LC, particularly those who are not currently recommended for HZ vaccination, were at an increased risk of HZ and HZ-related hospitalization compared with the general Korean population.
关于肝硬化（LC）与带状疱疹（HZ）风险之间的关联，现有数据有限。本研究旨在确定 LC 患者发生 HZ 的风险。
HZ 定义为存在国际疾病分类第 10 版 HZ 编码和同时开具抗病毒药物。使用韩国健康保险审查与评估服务的医疗保险索赔数据库中 2009 年至 2019 年的数据，分析 LC 患者 HZ 的发病率和标准化发病率比（SIR）。
共纳入 504986 例韩国 LC 患者。平均年龄为 52.4 岁，其中 60.8%为男性。慢性乙型肝炎是 LC 最常见的病因。HZ 和 HZ 相关住院的发病率分别为 1000 人中有 21.6 例和 1000 人中有 1.81 例。HZ 和 HZ 相关住院的 SIR 分别为 1.09（95%置信区间[CI]：1.08-1.09）和 1.48（95%CI：1.44-1.52），明显高于一般人群。年龄为 20-29、30-39 和 40-49 岁的 LC 患者的 HZ SIR 分别为 1.41（95%CI：1.33-1.48）、1.16（1.13-1.19）和 1.17（1.13-1.19）。多变量分析显示，女性（调整后的危险比[AHR]：1.48）、类固醇（AHR：1.20）、免疫抑制剂使用（AHR：1.26）和合并共存疾病与 LC 患者 HZ 风险增加相关。
与一般韩国人群相比，LC 患者，特别是目前不推荐进行 HZ 疫苗接种的患者，发生 HZ 和 HZ 相关住院的风险增加。
