ArticleArthritis & rheumatology (Hoboken, N.J.)2017
Herpes Zoster and the Risk of Stroke in Patients With Autoimmune Diseases.
Article in Arthritis & rheumatology (Hoboken, N.J.), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 4 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Viral Infections and Risk of Cardiovascular Disease: Systematic Review and Meta-Analysis.Journal of the American Heart Association · 2025Pooled it
- Stroke risk after varicella-zoster virus infection: a systematic review and meta-analysis.Journal of neurovirology · 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
- Mitigating Vaccine Disparities Through Faith-Based Intervention: A Pre-Post Analysis of Recombinant Zoster Vaccine Knowledge and Acceptance in Socially Vulnerable Racial and Ethnic Minoritized Communities.Infectious diseases and therapy · 2026Article
- 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
- Varicella zoster virus (VZV)-specific immunity and subclinical VZV reactivation in patients with autoimmune diseases.The Korean journal of internal medicine · 2021Article
- Herpes Zoster Vaccine Live and Risk of Stroke Among Medicare Beneficiaries: A Population-Based Cohort Study.Stroke · 2021Article
- Article
- Herpes Zoster: Epidemiological Links With Stroke and Myocardial Infarction.The Journal of infectious diseases · 2018Article
- Herpes Zoster as a Risk Factor for Incident Giant Cell Arteritis.Arthritis & rheumatology (Hoboken, N.J.) · 2017Article
- The alpha-herpesviridae in dermatology : Varicella zoster virus.Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete · 2017Review
- Study of the natural course and specific immunity after herpes zoster in patients with rheumatoid arthritis receiving biologic DMARDs.Mediterranean journal of rheumatology · 2017Article
- Serious adverse events and the risk of stroke in patients with rheumatoid arthritis: results from the German RABBIT cohort.Annals of the rheumatic diseases · 2017Article
- Significant Associations of Neurological Complications of Herpes Zoster With Stroke in Rheumatoid Arthritis Patients.Journal of the American Heart Association · 2017Article
- [The alpha-herpesviridae in dermatology : Varicella zoster virus. German version].Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete · 2017Review
- Comorbidities: Stroke risk increased after herpes zoster infection.Nature reviews. Rheumatology · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveHerpes zoster (HZ) is an opportunistic infection caused by varicella-zoster virus and observed with increasing frequency in patients receiving immunosuppressive therapies. The literature has suggested that the risk of stroke may increase shortly after HZ, but little is known about this association in patients with autoimmune diseases, who are at increased risk of both zoster and stroke.
methodsMedicare data from January 1, 2006 through December 31, 2013 were used to identify patients with autoimmune diseases. The outcome of interest was hospitalized stroke. The hypothesis tested was that the incidence of stroke immediately following HZ is increased compared to the incidence of stroke at later time points. Secondary analyses included assessment of the impact of antiviral therapy on subsequent stroke, as well as the influence of varicella-zoster virus-related complications on stroke incidence.
resultsThe crude incidence of stroke ranged from a high of 2.30 per 100 patient-years (95% confidence interval [95% CI] 0.96-5.52) within 90 days of HZ in patients who had HZ-related cranial nerve complications and did not receive treatment to a low of 0.87 per 100 patient-years (95% CI 0.75-1.02) at 366-730 days in those without complication who received antiviral treatment. After multivariable adjustment for multiple stroke-related factors, the overall incidence rate ratio (IRR) for stroke in the first 90 days after HZ was 1.36 (95% CI 1.10-1.68) compared to stroke occurring at 366-730 days after HZ. The risk was greater for patients with zoster and cranial nerve complications (IRR 2.08 [95% CI 0.99-4.36]). Prompt antiviral therapy was associated with lower incidence of subsequent stroke (IRR 0.83 [95% CI 0.70-0.98]).
conclusionIn patients with autoimmune diseases, incident HZ was associated with as much as a 2-fold increased risk of stroke in the subsequent few months. These data underscore the urgency of developing strategies for reducing the risk of varicella-zoster virus.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.