From the Department of Dermatology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
School of Public Health, National Defense Medical Center, Taipei, Taiwan.
Dermatitis. 2023 May-Jun;34(3):241-249. doi: 10.1089/derm.2022.0094. Epub 2023 Apr 19.
In the wake of the emerging development of biologics in atopic dermatitis (AD), herpes zoster (HZ) infection has been reported as a treatment-related adverse event. This study aims at investigating the association between AD and HZ, and the risk factors within. 28,677 participants with AD from the Taiwan National Health Insurance Research Database 2000-2015 were enrolled. Risk of HZ infection was compared in the study cohort (with AD) and the control cohort (without AD). Further analyses were conducted in gender-, age-, and treatment strategy-stratified subgroups. Significantly higher adjusted hazard ratios (aHRs) of HZ infection were revealed in AD patients (aHR = 2.303, < 0.001), and remained this trend in gender- and age-stratified models. All AD groups, irrespective of the treatment type, had higher aHRs (AD without systemic treatment: aHR = 2.356, < 0.001; AD with systemic treatment: aHR = 2.182, < 0.001) compared with those without AD. However, no differences in HZ risk were shown between each treatment type. Risk of HZ infection in AD is higher irrespective of treatment type. Considering that AD increases susceptibility to HZ infection, the administration of biologics requires careful considerations.
在特应性皮炎（AD）生物制剂新兴发展的背景下，已有报道称带状疱疹（HZ）感染是一种与治疗相关的不良事件。本研究旨在探讨 AD 与 HZ 之间的关联，以及其中的危险因素。研究纳入了来自 2000-2015 年台湾全民健康保险研究数据库的 28677 名 AD 患者。在研究队列（AD 组）和对照组（无 AD 组）中比较了 HZ 感染的风险。进一步在性别、年龄和治疗策略分层亚组中进行了分析。AD 患者 HZ 感染的调整后危险比（aHR）显著升高（aHR=2.303，<0.001），且在性别和年龄分层模型中仍保持此趋势。所有 AD 组，无论治疗类型如何，与无 AD 者相比，aHR 均较高（无全身治疗的 AD：aHR=2.356，<0.001；有全身治疗的 AD：aHR=2.182，<0.001）。然而，每种治疗类型之间的 HZ 风险无差异。AD 患者 HZ 感染风险无论治疗类型如何均较高。鉴于 AD 增加 HZ 感染的易感性，生物制剂的应用需要慎重考虑。
