People at the highest risk of shingles have the lowest chance of being eligible for vaccination, researchers say today.
Shingles, or herpes zoster, occurs when the commonly-carried virus that causes chickenpox reactivates. It affects half of those who live to 85 years of age, with risk increasing over the lifetime.
The painful rash of shingles usually lasts two to four weeks, but complications can occur, such as post-herpetic neuralgia which develops in 12% of patients aged 50 or over. This causes intense pain that can last for years.
There is a live shingles vaccine which is routinely available for people aged 70 or above in the UK. A "catch-up" campaign is also under way for 72 to 79 year olds, based on cost-effectiveness studies.
Researchers led by Dr Harriet Forbes of the London School of Hygiene and Tropical Medicine, UK, looked at the possible risk factors for shingles at different ages. They examined figures on 144,959 adults aged around 62 and diagnosed with shingles between 2000 and 2011, and compared them against 549,336 similar adults without shingles.
Shingles was 46% more likely among adults with rheumatoid arthritis, 36% more likely with inflammatory bowel disease, 32% with chronic obstructive pulmonary disease, and 21% with asthma. Risk was also raised to a lesser extent among those with chronic kidney disease, depression, and type 1, but not type 2, diabetes.
Details appear in the British Medical Journal.
"The relative effects of many assessed risk factors were larger in younger patients," the authors report.
"Patients with severely immunosuppressive conditions were at greatest risk – for example, patients with lymphoma and myeloma, who are not eligible for shingles vaccination," they add.
Forbes, H. J. et al. Quantification of risk factors for herpes zoster population based case-control study. BMJ 14 May 2014 doi: 10.1136/bmj.g2911 [abstract]
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