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Incidence and risk factors of herpes zoster among adult renal transplant recipients receiving universal antiviral prophylaxis
- Source :
- BMC Infectious Diseases
- Publisher :
- Springer Nature
-
Abstract
- Background Herpes zoster (HZ) is a significant cause of morbidity and complications in adult renal transplant recipients. We determined the incidence, complications and risk factors for the development of HZ after renal transplantation in a setting using universal antiviral prophylaxis. Methods The medical files of all adult renal transplants, performed between 2004 and 2008, were retrospectively reviewed to assess the clinical characteristics and risk factors of HZ. Incident cases of HZ were determined and the probability of developing post-transplant HZ for all subjects was calculated using the Kaplan Meier method. A multivariable Cox proportional hazards model was applied to assess the risk factors associated with the development of HZ. Results A total of 450 patients were eligible with a median follow up of 38 months. Twenty nine subjects (6.4 %) developed HZ, the median time to onset was 18 months, only three of them (10.3 %) required hospitalization, and none developed disseminated or visceral disease and death directly attributed to zoster. However, high rates of post-herpetic neuralgia (48.7 %) were observed. Overall incidence was calculated at 20.6 cases per 1000 patient-years of follow-up. Following multivariate analysis, increased age ≥ 60 years old, positive pre-transplant history of varicella related disease and administration of rejection treatment conferred an increased risk of 4.00-fold (CI: 1.79- 8.92), 16.00-fold (CI: 4.62- 55.52), and 5.57-fold (CI: 1.56- 19.84) respectively, for the development of post-transplant zoster. Conclusions HZ remains a common complication after renal transplantation in adults under current immunosuppession protocols and universal antiviral prophylaxis. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-1038-1) contains supplementary material, which is available to authorized users.
- Subjects :
- Adult
Male
medicine.medical_specialty
Complications
Adolescent
Herpes zoster
Neuralgia, Postherpetic
PHN
030230 surgery
Antiviral Agents
Chemoprevention
03 medical and health sciences
Young Adult
0302 clinical medicine
Chickenpox
Median follow-up
Risk Factors
Internal medicine
medicine
Adults
Humans
030212 general & internal medicine
Young adult
Kidney transplantation
HZ
Aged
Retrospective Studies
Proportional hazards model
business.industry
Post- herpetic neuralgia
Incidence (epidemiology)
Incidence
Retrospective cohort study
Renal transplantation
Middle Aged
medicine.disease
Kidney Transplantation
Transplant Recipients
3. Good health
Surgery
Transplantation
Infectious Diseases
Virus Diseases
Female
business
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14712334
- Volume :
- 15
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Infectious Diseases
- Accession number :
- edsair.doi.dedup.....38af3cde10e6e9eb736a9fbbaa566e72
- Full Text :
- https://doi.org/10.1186/s12879-015-1038-1