Osteoporosis: is Shingles a Risk Factor ?

-Shingles is a common condition which appeared following the reactivation of chicken pox.

-This retrospective study shows a high relative risk of developing shingles which is 4 and a half times higher than in those not having developed shingles. A slightly higher odds was demonstrated in patients having developed pain after shingles (postherpetic neuralgia).

-Taking into account the very high incidence of osteoporosis and its subsequent morbidity, especially in post-menopausal women, Bone density tomography might be indicated to perform soon and thereafter regularly in women having had shingles although the study does not really indicate at what age or how frequently it should be done.

Would a vaccine against Shingles prevent osteoporosis ?

-A vaccine against shingles is available and it would be interesting to see its potential beneficial effects. It might be indicated for a vaccination as early as possible as postherpetic neuralgia only appears to cause a relatively small increment of risk.

-Please see the abstract below (Study from Kaohshiung, Taiwan)

Abstract

Background

-Herpes Zoster (HZ), a latent neurotrophic viral disease caused by the varicell-zoster virus, can cause postherpetic neuralgia and the releasee of inflammatory signals. Osteoporosis is a major public health problem in the elderly and women, especially Asian descent. Chronic inflammation can decrease bone mass.

Objectives

To investigate the risk of osteoporosis in patients with HZ  infection using a nationwide population-based dataset.

Methods

The Taiwan National Health Insurance Research Database was used to compare 11 088 patients aged 20 to 48 years diagnosed with HZ during 1996 to 2010 and a control group of 11 088 patients without HZ. Cox proportional-hazards regression and Kaplan-Meier analyses were used to calculate hazard ratio and cumulative incidences of osteoporosis, respectively.

Results

The overall risk of osteoporosis was 4.55 times greater in the HZ group than the control group after adjusting for covariates. Besides, patients with HZ and postherpetic neuralgia had a 4.76-fold higher likelihood of developing osteoporosis (p below 0.001).

Conclusions

HZ is associated with an increased osteoporosis risk. Therefore, further arrangement of bone mineral density test in detecting osteoporosis after HZ may be suggested.

Comments

-This is retrospective study

-Does the fact of diagnosing shingles increase the incidence (subconscious) of having an increased proactive attitude to record more diagnoses. It would be interesting to see if this trend in increased Shingles incidence is also observed in other diseases (Hypertension, Diabetes, Neoplasia, Infections…)

P04-28. Herpes Zoster is a risk factor for osteoporosis. Lu YY et al. Japanese Society for Investigative Dermatology 2016 – Sendai. Japan