PDF(Pubmed)
Abstract：
BACKGROUND: Celiac Disease (CD) is associated with increased susceptibility to certain bacterial and viral infections. Herpes zoster (HZ) is a viral infection that can be prevented by immunization. In the US, the vaccine is recommended for adults ≥ 50 or ≥ 19 with certain at-risk conditions, not including CD.
OBJECTIVE: We aimed to determine if adult patients aged < 50 or ≥ 50 years with CD had a higher risk of developing HZ.
METHODS: We designed a retrospective cohort study. CD was defined as patients with the ICD-10 code for CD and positive Celiac serology. Patients with negative serology and lacking CD ICD-10 codes served as controls. Patients who had HZ before CD diagnosis were excluded. We formed two sub-cohorts, those aged < 50 (cohort 1) and aged ≥ 50 years (cohort 2), and evaluated HZ infection at 10-year follow-up. To account for confounding variables, we performed 1:1 propensity score matching (PSM).
RESULTS: Following PSM, cohort 1 had 6,826 CD patients, and cohort 2 had 5,337 CD patients and respective matched controls. After ten years of follow-up, in cohort 1, 62 CD patients developed HZ versus 57 controls, RR: 1.09 (CI: 0.76-1.56, p-value = 0.64). In cohort 2, 200 CD patients developed HZ versus 159 controls, RR: 1.2 (CI: 1.02-1.54, p-value = 0.03).
CONCLUSIONS: There was no significant difference in the likelihood of getting HZ in CD patients < 50, although CD patients ≥ 50 had a modestly increased risk. Our findings do not support routine early vaccination for HZ in CD, and the vaccine should be offered at age 50.
OBJECTIVE: We aimed to determine if adult patients aged < 50 or ≥ 50 years with CD had a higher risk of developing HZ.
METHODS: We designed a retrospective cohort study. CD was defined as patients with the ICD-10 code for CD and positive Celiac serology. Patients with negative serology and lacking CD ICD-10 codes served as controls. Patients who had HZ before CD diagnosis were excluded. We formed two sub-cohorts, those aged < 50 (cohort 1) and aged ≥ 50 years (cohort 2), and evaluated HZ infection at 10-year follow-up. To account for confounding variables, we performed 1:1 propensity score matching (PSM).
RESULTS: Following PSM, cohort 1 had 6,826 CD patients, and cohort 2 had 5,337 CD patients and respective matched controls. After ten years of follow-up, in cohort 1, 62 CD patients developed HZ versus 57 controls, RR: 1.09 (CI: 0.76-1.56, p-value = 0.64). In cohort 2, 200 CD patients developed HZ versus 159 controls, RR: 1.2 (CI: 1.02-1.54, p-value = 0.03).
CONCLUSIONS: There was no significant difference in the likelihood of getting HZ in CD patients < 50, although CD patients ≥ 50 had a modestly increased risk. Our findings do not support routine early vaccination for HZ in CD, and the vaccine should be offered at age 50.
摘要：
背景：乳糜泻（CD）与某些细菌和病毒感染的易感性增加有关。带状疱疹（HZ）是一种可以通过免疫预防的病毒感染。在美国,该疫苗推荐用于年龄≥50岁或≥19岁的成年人，不包括CD。
目的：我们的目的是确定年龄<50岁或≥50岁的成人患者是否有更高的发展为HZ的风险。
方法：我们设计了一项回顾性队列研究。CD被定义为具有CD的ICD-10代码和乳糜泻血清学阳性的患者。血清学阴性且缺乏CDICD-10代码的患者作为对照。排除在CD诊断之前患有HZ的患者。我们组成了两个小组，年龄<50岁(队列1)和年龄≥50岁(队列2)，并在10年随访时评估HZ感染。要考虑混杂变量，我们进行了1:1倾向评分匹配（PSM）。
结果：在PSM之后，队列1有6,826名CD患者，和队列2有5,337名CD患者和相应的匹配对照。经过十年的随访，在队列1中，62例CD患者发展为HZ，而57例对照，RR：1.09（CI：0.76-1.56，p值=0.64）。在队列2中，200例CD患者发展为HZ，而对照组为159例，RR：1.2（CI：1.02-1.54，p值=0.03）。
结论：在<50岁的CD患者中，尽管≥50岁的CD患者的风险略有增加，但在得HZ的可能性上没有显著差异。我们的发现不支持在CD中常规早期接种HZ疫苗，疫苗应该在50岁时提供。
目的：我们的目的是确定年龄<50岁或≥50岁的成人患者是否有更高的发展为HZ的风险。
方法：我们设计了一项回顾性队列研究。CD被定义为具有CD的ICD-10代码和乳糜泻血清学阳性的患者。血清学阴性且缺乏CDICD-10代码的患者作为对照。排除在CD诊断之前患有HZ的患者。我们组成了两个小组，年龄<50岁(队列1)和年龄≥50岁(队列2)，并在10年随访时评估HZ感染。要考虑混杂变量，我们进行了1:1倾向评分匹配（PSM）。
结果：在PSM之后，队列1有6,826名CD患者，和队列2有5,337名CD患者和相应的匹配对照。经过十年的随访，在队列1中，62例CD患者发展为HZ，而57例对照，RR：1.09（CI：0.76-1.56，p值=0.64）。在队列2中，200例CD患者发展为HZ，而对照组为159例，RR：1.2（CI：1.02-1.54，p值=0.03）。
结论：在<50岁的CD患者中，尽管≥50岁的CD患者的风险略有增加，但在得HZ的可能性上没有显著差异。我们的发现不支持在CD中常规早期接种HZ疫苗，疫苗应该在50岁时提供。
