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Vaccination, antiviral treatment fails to affect stroke risk from herpes zoster

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Contracting herpes zoster increased risk for acute ischemic stroke, and among patients with herpes zoster, vaccination or antiviral treatment did not modify the risk, according to data presented at the International Stroke Conference.

Previous studies had shown that herpes zoster increases risk for acute ischemic stroke, but none had evaluated the effect of vaccination or antiviral treatment after herpes zoster infection on stroke risk, Quanhe Yang, PhD, senior scientist with the epidemiology and surveillance branch in the CDC’s Division for Heart Disease and Stroke Prevention, and colleagues wrote in an abstract.

The researchers analyzed 35,186 Medicare fee-for-service beneficiaries who were diagnosed with herpes zoster and acute ischemic stroke between 2007 and 2015.

Participants were stratified into four groups: those with no vaccination or antiviral treatment (49%), those with vaccination but no antiviral treatment (9%), those with antiviral treatment but no vaccination (34%) and those with both vaccination and antiviral treatment (8%).

Incident rate ratios for acute ischemic stroke were 1.61 (95% CI, 1.51-1.7) at 0 to 14 days, 1.35 (95% CI, 1.27-1.44) at 15 to 30 days, 1.16 (95% CI, 1.12-1.2) at 31 to 90 days, and 1.05 (95% CI, 1.02-1.08) at 91 to 180 days, according to the researchers.

Yang and colleagues found no effect modification due to vaccination or antiviral treatment (P for interaction = .6) after onset of herpes zoster. They also found the results were consistent regardless of race/ethnicity and sex.

“Risk of [acute ischemic stroke] increased significantly following [herpes zoster], and this increased risk didn’t appear to be modified by [herpes zoster] vaccination and antiviral treatment following [herpes zoster],” Yang and colleagues wrote in the abstract. “Primary prevention of [herpes zoster] by [herpes zoster] vaccination might be the most effective approach to prevent [herpes zoster]-associated [acute ischemic stroke].” – by Erik Swain

Reference:

Yang Q, et al. Abstract 39. Presented at: International Stroke Conference; Feb. 5-8, 2019; Honolulu.

Disclosures: The authors report no relevant financial disclosures.