Vaccine may help patients avoid herpes zoster recurrence

Recurrences of herpes zoster (HZ) may be more common in immunocompetent adults than once thought, according to a study published in the February issue of Mayo Clinic Proceedings, Newswise reported. This suggested that vaccine prevention, which is known to reduce first-time occurrences of HZ by 50%, might be an appropriate therapy in this patient population.

Researchers from the Olmsted Medical Center and Mayo Clinic in Rochester, Minn., and Merck Research Laboratories, North Wales, Pa., studied the medical records of 1,669 persons with a medically documented HZ episode. They analyzed recurrences by age, immune status, and presence of prolonged pain at the time of the incident HZ episode. The study group consisted of persons aged 22 years or older who had an incident HZ episode between January 1, 1996, and December 31, 2001.

Of the 1,669 persons, 95 had 105 recurrences (8 persons with >1 recurrence), over an average follow-up of 7.3 years. The 8-year recurrence rate, estimated using Kaplan-Meier curves, was 6.2%. The time between HZ episodes in the same person ranged from 96 days to 10 years over a maximum follow-up of 12 years.

Those persons with zoster-associated pain of 30 days or longer at the initial HZ episode were significantly more likely to have a recurrence (HR=2.80; 95% CI, 1.84–4.27; P<.001). Immunocompromised persons were also more likely to have recurrences (HR=2.35; 95% CI, 1.35–4.08; P=.006), as were women and anyone aged 50 years or older at the index episode.