A new study makes a strong case for patients with diabetes mellitus (DM) to be vaccinated against herpes zoster (HZ).
The article in the Journal of Clinical Endocrinology & Metabolism makes the case that those patients are susceptible to a range of infections. The study team, led by researchers from Mackay Memorial Hospital in Taiwan, set out to estimate the risk of HZ among diabetes patients compared with individuals in the general population.
To do that, the study team searched the PubMed, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and PerioPath databases from their inception to January 30, 2021, for studies on the risk of HZ in individuals with DM.
Two authors independently screened all articles identified and independently extracted the data. They included four case-control studies and 12 cohort studies in the meta-analysis.
Results indicate that, in the pooled analysis, DM patients had a higher risk of developing HZ (pooled relative risk: 1.38, 95% confidence interval: 1.21-1.57) than individuals in the general population. "The results were consistent in subgroup analyses stratified by type of diabetes, age, and study design. In individuals with DM, cardiovascular disease had an additive effect on increasing the risk of HZ (pooled relative risk: 1.19, 95% confidence interval: 1.11-1.28)," the authors noted. "There was a linear dose-response association between age and the risk of HZ in individuals with DM."
The researchers continued, "Varicella vaccination should be provided to individuals with DM regardless of their age, prioritizing older adults and those with cardiovascular disease. Varicella vaccination policies for individuals with DM should be updated based on the evidence."
Another study from Taiwan earlier this year sought to determine the incidence of HZ in DM patients. That meta-analysis, based on five cohort studies, determined that the pooled incidences of HZ in patients with DM and in patients without DM were 7.22 and 4.12 per 1,000 person-years.
The overall risk of developing HZ was significantly higher in patients with DM compared with those with no DM (incidence rate ratio = 1.60, 95% confidence interval = 1.33-1.93), according to the report in Medicine (Baltimore). "Patients with diabetes mellitus are substantially at increased risk for the development of herpes zoster. Patients with diabetes mellitus should take into consideration the vaccination to prevent herpes zoster," those researchers recommended.
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