Monday, February 10, 2014

Statins and the Increased Incidence of Herpes Zoster (Shingles)

As I was perusing medical journals this weekend I came across this interesting study in Clinical Infectious Diseases.

Statins are some of the most commonly prescribed medications on the market, particularly in elderly patients. Although by no means conclusive, in this retrospective cohort study of Ontario residents (age >65), the rate of herpes zoster was higher among users of statins relative to nonusers of these drugs (13.25 vs 11.71 per 1000 person-years, respectively; hazard ratio [HR], 1.13; 95% confidence interval [CI], 1.10-1.17). The 13% increased risk of herpes zoster is presumably due to the immunodulatory properties of statins. 

Although the absolute risk is low, from the study above, the authors estimate that as many as 20,000 cases of herpes zoster are associated with statin use. Not insignificant.

If these results can be replicated, the findings will be of public health importance.  Physicians will need to be aware of statin use, particularly in the elderly, and should advocate for herpes zoster vaccination of these patients.

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