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Côté-Daigneault J, Bessissow T, Nicolae MV, Nie R, Bitton A, Lakatos PL, Brassard P. Herpes Zoster Incidence in Inflammatory Bowel Disease Patients: A Population-Based Study. Inflamm Bowel Dis 2019; 25:914-918. [PMID: 30295818 DOI: 10.1093/ibd/izy311] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND The aberrant immune response in inflammatory bowel disease (IBD) and immunosuppression may intrinsically predispose patients to infectious complications, such as herpes zoster (HZ). We quantified the incidence of HZ in IBD patients in the province of Quebec, Canada. METHODS We performed a descriptive study using the provincial "Regie de l'Assurance Maladie du Québec" (RAMQ) health registry from 1996 to 2015. The study population consisted of all subjects in the source population who fulfilled the CD and UC case-defining criteria. HZ incidence rates (IRs) in person-years (py) were calculated according to age groups, sex, Charlson Comorbidity index (CCI), and IBD type. Age standardized incidence ratios (SIRs) were performed using the Quebec general population as reference. RESULTS A total of 39,366 patients met the diagnostic criteria of either Crohn's disease (CD; n = 23,388), ulcerative colitis (UC; n = 14,513), or IBD unclassified (n = 1465). We identified 2158 HZ cases. Crude IR was 6.67 cases/1000 py and 7.22 cases/1000 py for CD and UC patients, respectively. Unclassified IBD crude HZ IR was 7.54 cases/1000 py. No significant time trend was identified. HZ incidence is high in IBD patients >50 years of age and among the very young (0-17 years of age; SIR, 3.38; 95% confidence interval, 2.64-4.26), especially females. CONCLUSIONS These data suggest that HZ incidence is high in the IBD population. Preventives measures should be implemented in this at-risk population.
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Affiliation(s)
- Justin Côté-Daigneault
- Division of Gastroenterology, CHUM/CRCHUM, Université de Montréal, Montreal, QC, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Talat Bessissow
- Division of Gastroenterology, McGill University Health Centre, Montreal General Hospital, Montreal, QC, Canada
| | - Maria Vutcovici Nicolae
- Division of Gastroenterology, McGill University Health Centre, Montreal General Hospital, Montreal, QC, Canada
| | - Rui Nie
- Center for Clinical Epidemiology, Lady Davis Research Institute, Jewish General Hospital, Montreal, QC, Canada
| | - Alain Bitton
- Division of Gastroenterology, McGill University Health Centre, Montreal General Hospital, Montreal, QC, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada
| | - Peter Laszlo Lakatos
- Division of Gastroenterology, McGill University Health Centre, Montreal General Hospital, Montreal, QC, Canada.,1st Department of Medicine, Semmelweis University, Budapest, Hungary
| | - Paul Brassard
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,Center for Clinical Epidemiology, Lady Davis Research Institute, Jewish General Hospital, Montreal, QC, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada
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