Shingles risk increases in people with lupus, COPD, and rheumatoid arthritis

By: Dr. Victor Marchione | General Health | Thursday, February 04, 2016 - 01:30 PM

Shingles risk increases in people with lupus, COPD, and rheumatoid arthritisShingles risk increases in people with lupus, COPD, and rheumatoid arthritis. Shingles is a painful skin rash caused by the varicella zoster virus, which is the same virus responsible for chickenpox. When a person contracts the chickenpox, the virus remains dormant in the body, but when it becomes active again, it can result in shingles, which commonly occurs in adults.

A study published in Lupus found that lupus patients had a 70 percent higher risk of shingles, compared to individuals without inflammatory diseases. There have been other studies as well, which found higher risk of shingles in lupus patients. Researchers believe it has to do with cell-mediated immunity in lupus patients, along with immunosuppressant medications, which many of them take to manage lupus.

The investigators of the study compared cases of shingles in lupus patients to individuals with non-inflammatory musculoskeletal conditions. They collected data from semi-annual questionnaires, which were submitted to the National Data Bank for Rheumatic Diseases (NDB) between 2001 and 2009.

Based on their comparison and findings, the investigators concluded that lupus patients have a 70 percent higher risk of developing shingles, compared to individuals without inflammatory diseases. Patients who took prednisone or mycophenolate mofetil saw a greater risk of developing shingles, unlike with other lupus-related medications.

Although lupus patients are at highest risk for shingles, they have the lowest vaccination rates – which could further contribute to the risk. A vaccine for shingles is available, and regardless of whether one has lupus or not, we should all take advantage of the vaccine in order to reduce our risk.

The good news here is, shingles isn’t contagious as long as a person has experienced chickenpox prior in their life. If not, then the virus can be passed from person to person causing chickenpox. Depending on a person’s age, shingles can lead to complications, so it’s best advised to simply get vaccinated.

COPD, rheumatoid arthritis, and lupus patients at high risk for shingles

COPD, rheumatoid arthritis, and lupus patients are at a higher risk for shingles, compared to individuals without these conditions. Researchers from the London School of Hygiene and Tropical Medicine found that rheumatoid arthritis (RA) patients have over a 30 percent higher risk of shingles, along with those with COPD.

In Australia and the U.S., the shingles vaccine is recommended for adults over the age of 60, but in the U.K. the vaccine is intended for those over the age of 70. Lead researcher Harriet J. Forbes wrote, “As the zoster vaccine is expensive, targeting vaccination towards groups at high risk of zoster is necessary. Age is the most important risk factor for zoster and postherpetic neuralgia, so it drives vaccination policies.”

The research team analyzed data from the Clinical Practice Research Datalink and Hospital Episodes Statistics. They identified 144,959 shingles cases and matched each patient with four controls.

Aside from RA, COPD, and lupus, other conditions – depression, inflammatory bowel diseases, and type 1 diabetes – were found to be the risk factors for shingles.

The researchers found that the risk of shingles in RA, COPD, and lupus patients declined with age. This had them question whether or not it would be beneficial to begin shingles vaccination at a younger age. They wrote, “This raises the question of whether vaccination of certain younger, high-risk groups may be beneficial; cost effectiveness studies, also considering the risk of postherpetic neuralgia, would be needed to answer this question.”

If you have an autoimmune or chronic disease, your risk of shingles is higher, compared to the general population. As mentioned, if you are in a high-risk group, getting vaccinated can lower your risk – and the risk of complications as well.


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Related Reading:

Shingles risk rises in primary Sjögren’s syndrome affected adults

Rare eye inflammation linked with chickenpox, shingles vaccine

Sources:

http://www.lupus.org/research-news/entry/increased-incidence-of-shingles-in-people-with-lupus
http://lup.sagepub.com/content/22/3/238.abstract
http://www.medpagetoday.com/Geriatrics/Vaccines/45761
http://www.bmj.com/content/348/bmj.g2911

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