ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2014
Risk of stroke following herpes zoster: a self-controlled case-series study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 74 papers, 8 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
74 citing papers in PubMed, 8 syntheses or guidelines pooled it, 153 citations in OpenAlex.
- Viral Infections and Risk of Cardiovascular Disease: Systematic Review and Meta-Analysis.Journal of the American Heart Association · 2025Pooled it
- Impact of influenza, herpes zoster, and pneumococcal vaccinations on the incidence of cardiovascular events in subjects aged over 65 years: a systematic review.GeroScience · 2023Pooled it
- Effects of herpes zoster vaccination and antiviral treatment on the risk of stroke: a systematic review and meta-analysis.Frontiers in neurology · 2023Pooled it
- Pooled it
- A meta-analysis of stroke risk following herpes zoster infection.BMC infectious diseases · 2017Pooled it
- A systematic review and meta-analysis on herpes zoster and the risk of cardiac and cerebrovascular events.PloS one · 2017Pooled it
- Herpes zoster and the risk of ischemic and hemorrhagic stroke: A systematic review and meta-analysis.PloS one · 2017Pooled it
- Pooled it
- Herpes Zoster Vaccination as Cardiovascular Prevention in Adults with Heart Disease.Cardiovascular drugs and therapy · 2026Review
- Neuro- and cardioprotective benefits of recombinant herpes zoster vaccination.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026Article
- Association between shingles vaccination and slower biological aging: evidence from a US population-based cohort study.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Article
- Review
- Cerebral vasculitis as a severe complication of acute infectious meningoencephalitis-a case series of five different pathogens.Wiener medizinische Wochenschrift (1946) · 2025Article
- Sequelae of viral CNS infections including outcomes, mechanisms, and knowledge gaps.Npj viruses · 2025Review
- Live zoster vaccination and hepatobiliary risk reduction: a nationwide South Korean study.The Korean journal of internal medicine · 2025Article
- Microvascular Density Analysis of Patients with Trigeminal Herpes Zoster-An Optical Coherence Tomography Angiography Study.Biomedicines · 2025Article
- Real-world data on the use of the Shingrix vaccine among patients with inflammatory arthritis and risk of cardiovascular events following herpes zoster.Arthritis research & therapy · 2025Observational
- Post-infectious central nervous system vasculitides in adults: an underdiagnosed and treatable disease part II. Neuroimaging of selected etiologies : Part II. Neuroimaging of selected etiologies.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Review
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14 more citing papers are in PubMed but not listed here.
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundHerpes zoster is common and vaccine preventable. Stroke risk may be increased following zoster, but evidence is sparse and could be explained by differences between people with and without zoster. Our objective was to determine if stroke risk is increased following zoster.
methodsWithin-person comparisons were undertaken using the self-controlled case-series method and data from the UK Clinical Practice Research Datalink (1987-2012). Participants had a first-ever diagnosis of zoster and stroke within the study period. Stroke incidence in periods following zoster was compared with incidence in other time periods. Age-adjusted incidence ratios (IRs) and 95% confidence intervals (CIs) were calculated.
resultsA total of 6584 individuals were included. Stroke rate was increased following zoster compared with the baseline unexposed period, then gradually reduced over 6 months: weeks 1-4 (age-adjusted IR, 1.63; 95% CI, 1.32-2.02), weeks 5-12 (IR, 1.42; 95% CI, 1.21-1.68), and weeks 13-26 (IR, 1.23; 95% CI, 1.07-1.42), with no increase thereafter. A stronger effect was observed for individuals with zoster ophthalmicus, rising to a >3-fold rate 5-12 weeks after zoster. Oral antivirals were given to 55% of individuals: IRs for stroke were lower among those receiving antivirals compared with those not treated, suggesting a protective effect.
conclusionsWe have established an increased stroke rate within 6 months following zoster. Findings have implications for zoster vaccination programs, which may reduce stroke risk following zoster. The low antiviral prescribing rate needs to be improved; our data suggest that antiviral therapy may lead to a reduced stroke risk following zoster.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.