Introduction Although varicella zoster virus (VZV)-induced vasculopathy and stroke after herpes zoster (HZ) attacks have been previously reported, data regarding stroke frequency after zoster attacks are lacking. This study investigates the risk of stroke after HZ in a general population age 50 years and older.
Methods This is a retrospective cohort study of HZ cases who had received treatment for HZ from 1 January 2007 to 31 October 2010 at Kaiser Permanente Southern California. These cases had no records of stroke within 1 year prior to their index HZ diagnosis date. The comparison cohort included subjects who had no HZ during the same period and were matched 1:1 to the HZ cohort on age, date of HZ diagnosis, and the setting of medical care. Incident cases of stroke were identified from hospitalisation records with primary diagnosis as stroke.
Results There were 227 stroke cases in the HZ cohort and 224 in the comparison cohort. The 1-year Kaplan-Meier cumulative incidence of stroke was 0.88% (95% CI 0.77% to 1.00%) for the HZ cohort and 0.89% (95% CI 0.78% to 1.00%) for the comparison cohort (p value: 0.98). The HR of stroke after any HZ or herpes zoster ophthalmicus, after controlling for sex, race, heart diseases, diabetes, lung diseases, kidney diseases, liver diseases, hypertension, and demential status was 1.11 (95% CI 0.92 to 1.33) and 3.33 (95% CI 1.05 to 10.53), respectively.
Conclusions These data suggest that the risk of stroke following herpes zoster was increased in only those with ophthalmic involvement and not in subjects with HZ involved in distant dermatomes.
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