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Incidence of herpes zoster in adult solid organ transplant recipients: A meta-analysis and comprehensive review

Authors
 Da Eun Kwon  ;  Hye Sun Lee  ;  Kyoung Hwa Lee  ;  Yeonju La  ;  Sang Hoon Han  ;  Yong Goo Song 
Citation
 TRANSPLANT INFECTIOUS DISEASE, Vol.23(4) : e13674, 2021-08 
Journal Title
TRANSPLANT INFECTIOUS DISEASE
ISSN
 1398-2273 
Issue Date
2021-08
MeSH
Adult ; Heart Transplantation* / adverse effects ; Herpes Zoster* / epidemiology ; Herpesvirus 3, Human ; Humans ; Incidence ; Transplant Recipients
Keywords
herpes zoster ; incidence ; meta-analysis ; solid organ transplantation
Abstract
Background: Chronic immunosuppressive therapy in solid organ transplant (SOT) recipients can trigger latent varicella zoster virus reactivation even in those with stable graft function. The inactivated herpes zoster (HZ) vaccine can be effective in preventing post-transplant HZ, which can cause severe neuralgia or disseminated disease. This meta-analysis aims to assess the incidences of HZ across transplant organs in SOT recipients.

Methods: We included 12 observational studies (6560 recipients) from a PubMed and EMBASE search of articles through October 2019 and collected data from single-center dating from January 2001 to December 2017 (3498 recipients). The pooled HZ incidence and its differences between subgroups were obtained from random-effect models and meta-analysis of variance tests using R package.

Results: The overall pooled crude incidence was 9.1% (95% confidence interval [CI], 7.6%-10.8%). The pooled incidence was similar between sexes but significantly different between transplanted organs (P < .001). Heart transplants (HT) (n = 644) have the highest pooled incidence with 15.2% (95% CI, 12.7%-18.2%), followed by lung transplants (LTX) (n = 780) with 11.0% (8.3%-14.4%). Kidney transplants (n = 5435) have the lowest incidence of 6.7 (5.1%-8.8%). The meta-regression analysis revealed that HZ development had a relationship with past graft rejection (P = .024).

Conclusion: These data support the need for subunit HZ vaccination in SOT recipients with a high risk for HZ, especially HT and LTX recipients, without respect to the late post-transplant period.
Full Text
https://onlinelibrary.wiley.com/doi/10.1111/tid.13674
DOI
10.1111/tid.13674
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kwon, Da Eun(권다은)
La, Yeonju(라연주)
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Lee, Kyoung Hwa(이경화) ORCID logo https://orcid.org/0000-0003-0033-1398
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Han, Sang Hoon(한상훈) ORCID logo https://orcid.org/0000-0002-4278-5198
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/185395
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