Shingles recurrence rate greater than previously suggested
MedWire News: The rate of recurrence of shingles, or Herpes zoster, is greater than previously reported, indicate study results.
The high recurrence rates seen in this study "suggest that zoster vaccination should be offered in people who have had a Herpes zoster episode to prevent potential recurrences," suggest Barbara Yawn, from Olmsted Medical Center in Rochester, Minnesota, USA and co-workers.
Yawn explained to MedWire News: "To date there has been little information about whether or not recurrences really do occur and how often they recur. This has made it difficult for physicians and patients to decide if a patient with previous shingles should or should not receive the shingles vaccine."
The researchers studied 1669 residents of Olmsted County in Minnesota, aged 22 years or older, who had a first case of shingles between January 1996 and December 2001. Yawn and team reviewed medical records through to 2007 to assess recurrence rates.
Over a mean follow-up period of 7.3 years (maximum of 12 years), 95 patients had 105 recurrences of shingles, with 8 individuals having more than one recurrence. This translated to a recurrence rate of 6.2% at 8 years.
Time between episodes of shingles varied considerably from 96 days to 10 years.
Writing in the Mayo Clinic Proceedings journal, the authors report that individuals who had shingles-associated pain that lasted for longer than 30 days after their first episode were 2.80-fold more likely to have a recurrence than those who had less long-lasting or no pain.
In addition, immunocompromised patients had a 2.35-fold increased risk for recurrence compared with immunocompetent individuals.
Other factors that increased the risk for recurrence included female gender, and age older than 50 years at initial occurrence.
Yawn explained that these findings "suggest that the chances of getting a second case is about as high as getting the first case," even among immunocompetent individuals.
For most people this would suggest the vaccine is appropriate to use in someone who has already had shingles, even if they are not immunocompromised, she commented.
The shingles vaccine is currently only available for patients aged 60 years or above, cautioned Yawn, but she added that she hopes it will soon be offered to individuals over the age of 50 years.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Helen Albert