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23-02-2011 | Respiratory | Article

COPD patients at increased risk for shingles


Free abstract

MedWire News: Results from a Taiwanese study suggest that patients with chronic obstructive pulmonary disease (COPD) are at increased risk for herpes zoster (shingles).

"Systemic inflammation and dysregulated immune function in COPD is hypothesized to predispose patients to development of herpes zoster," write Hui-Wen Lin (Taipei Medical University) and colleagues in the Canadian Medical Association Journal.

"However, the risk of herpes zoster among patients with COPD is undocumented," they add.

The team therefore studied data from the Taiwanese Longitudinal Health Insurance Database on 8486 patients with COPD, aged 50 years and older, and 33,944 age- and gender-matched controls without the respiratory condition.

In total, 321 COPD patients and 759 controls developed herpes zoster over mean follow-up periods of 27.7 and 30.9 months, respectively, with incidence rates of 16.4 versus 8.8 per 1000 person-years.

After accounting for factors such as age, gender, diabetes, and rheumatic diseases, the researchers found that patients with COPD were, overall, 1.68 times more likely to develop herpes zoster than controls.

Further analysis showed that the adjusted risk for herpes zoster among COPD patients varied with steroid use. Indeed, compared with controls, COPD patients taking oral steroids had the greatest risk for herpes zoster (hazard ratio [HR]=3.00), followed by patients taking inhaled corticosteroids (HR=2.09), and those who were not taking steroids (HR=1.67).

Lin and team conclude: "Our results suggest that COPD, like other inflammatory diseases (eg, rheumatoid arthritis, inflammatory bowel disease) was associated with an increased risk of herpes zoster relative to that in the general population."

They add: "To prevent the substantial morbidity ensuing from this vexing disease, it is recommended that patients with COPD receive zoster vaccination in addition to influenza and pneumococcal immunization."

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Mark Cowen

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