This article is more than 5 years old. Information may no longer be current.
IBD treatment increases children’s risk for varicella, herpes zoster hospitalization
Click Here to Manage Email Alerts
Children who receive immunosuppressive therapy for inflammatory bowel diseases are at an increased risk for varicella- and herpes zoster-related hospitalizations, according to recent research in The Journal of Pediatrics.
“We identified a significant association between [inflammatory bowel diseases (IBD)] and hospitalization for both varicella and herpes zoster among hospitalized children,” Daniel J. Adams, MD, and Cade M. Nylund, MD, both of the department of pediatrics at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. “The effect size of this association was comparable with that observed in children with HIV, malignancy, and primary immune deficiency.”
Daniel J. Adams
Cade M. Nylund
The researchers gathered data for 8,828,712 patients aged 5 to 20 years from the Healthcare Cost and Utilization Project Kids’ Inpatient Database for 1997 to 2012. To determine the association between IBD and varicella or herpes zoster, the researchers utilized ICD-9 billing codes for varicella, herpes zoster, immunocompromising conditions and IBDs, such as ulcerative colitis and Crohn’s disease.
Study data indicated that there were 4,434 hospitalized children with a primary diagnosis of varicella and 4,488 with a primary diagnosis of herpes zoster. The researchers cited an association between IBD and varicella or herpes zoster hospitalization. Children with Crohn’s disease were at a higher risk for varicella (OR = 12.75; 95% CI, 8.3-19.59) or herpes zoster hospitalization (OR = 7.91; 95% CI, 5.6-11.18) vs. children with ulcerative colitis (varicella, OR = 4.25; 95% CI, 1.98-9.12; herpes zoster, OR = 3.9; 95% CI, 1.98-7.67).
Adams and Nylund wrote that these results emphasized the importance of vaccinating children with IBD against varicella before initiating immunosuppressive therapy.
“Providers caring for children with IBD should screen them for varicella immunity routinely and make every effort to immunize susceptible patients,” the investigators wrote. “Delaying IBD treatment with immunosuppressant medications for the purpose of immunizing against varicella is not always a feasible option, and studies of both the safety and immunogenicity of varicella immunization in immunosuppressed children with IBD are urgently needed.” – by David Costill
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts