May 09, 2019
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Patients with IBD twice as likely to have herpes zoster

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Patients with inflammatory bowel disease have higher hospitalization rates for herpes zoster virus compared with other people without IBD, according to study results.

Daniella Guerrero-Vinsard, MD, of the department of internal medicine at University of Connecticut Health Center, and colleagues wrote in Inflammatory Bowel Diseases that patients with IBD are particularly susceptible to vaccine-preventable diseases, but current guidelines regarding vaccinations are backed up by lower-level evidence.

“The increased risk for infections in patients with IBD and other autoimmune conditions, as well as the lower rate of vaccination practices in this patient population, has been well-described,” they wrote. “Importantly, this risk is not only a result of immunosuppressive therapy necessary to control the disease but also secondary to the aberrant immunologic reactions intrinsic to the disease and its associated organ complications.”

Researchers conducted a population-based descriptive cohort study using United States Inpatient Sample ICD-9 codes from 2012 to 2015. They determined the frequency of patients with IBD who were admitted to the hospital with a vaccine-preventable disease and compared that with patients without IBD.

Of more than 14 million discharges, 596,485 (2.08%) were secondary to a vaccine-preventable disease. Of those patients, researchers found that 7,180 (1.2%) had a vaccine-preventable disease and IBD.

Among these patients, herpes zoster virus was the most common disease (34.9%), followed by hepatitis B (31.6%) and influenza (22.1%). Guerrero-Vinsard and colleagues found that patients with IBD were more than twice as likely to be hospitalized for herpes zoster virus than patients without IBD (OR = 2.3; 95% CI, 2.06–2.58).

However, patients with IBD had lower odds of having pneumococcal pneumonia (OR = 0.62; 95% CI, 0.52–0.74) and influenza (OR = 0.72; 95% CI, 0.63–0.81).

“Patients with IBD had a higher rate of hospital admissions with [herpes zoster virus] and a lower rate of pneumococcal pneumonia and influenza admissions as compared with the non-IBD population,” Guerrero-Vinsard and colleagues concluded. “Further research focusing on [herpes zoster virus] and IBD is warranted to determine the best immunization strategy in this patient population.” – by Alex Young

Disclosures: Healio Gastroenterology and Liver Disease could not confirm the authors’ relevant financial disclosures prior to publication.