Known risk factors for developing herpes zoster relate to the status of cell-mediated immunity to VZV. Risk factors in children and adults include the following:
VZV-specific immunity and cell-mediated immunity, which generally declines with age
Immunosuppression (eg, by HIV infection or AIDS)
Primary VZV infection in utero or in early infancy, when the normal immune response is decreased
Anti-TNF alpha agents (may pose an increased risk)
Immune reconstitution inflammatory syndrome
Acute lymphocytic leukemia and other cancers
Ophthalmic manifestations of herpes zoster infection include conjunctivitis, scleritis, episcleritis, keratitis iridocyclitis, Argyll Robertson pupil, glaucoma, retinitis, choroiditis, optic neuritis, optic atrophy, retrobulbar neuritis, exophthalmos, lid retraction, ptosis, and extraocular muscle palsies. The risk for ophthalmic complications in patients with herpes zoster does not seem to correlate with age, sex, or severity of the rash.
Research indicates that individuals with IBD are at significantly increased risk for herpes zoster. In an analysis of more than 108,000 patients with IBD and 430,000 matched controls, the overall annual incidence per 100,000 person-years was 734 among patients with IBD, compared with 437 in those without. The elevated risk in patients with IBD remained after adjustment for comorbidities and other factors.
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Cite this: William James. Fast Five Quiz: Shingles - Medscape - Dec 11, 2019.