SURVEY OF HERPES ZOSTER IN KIDNEY TRANSPLANT PATIENTS: A SINGLE-CENTER STUDY

 

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https://storage.unitedwebnetwork.com/files/1099/fdf572bcb497a8490dfff55703ed3091.pdf
SURVEY OF HERPES ZOSTER IN KIDNEY TRANSPLANT PATIENTS: A SINGLE-CENTER STUDY

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Kei
Sakurabayashi
Kei Sakurabayashi kei.sakurabayashi@med.toho-u.ac.jp toho university nephrology tokyo Japan *
Masaki Muramatsu masaki7419@gmail.com toho university nephrology tokyo Japan -
Yoshihiro Itabashi Itabashi itabag@med.toho-u.ac.jp toho university nephrology tokyo Japan -
Yujiro Aoki y.aoki@med.toho-u.ac.jp toho university nephrology tokyo Japan -
Takashi Yonekura takashi.yonekura@med.toho-u.ac.jp toho university nephrology tokyo Japan -
Maho Maeda maho.maeda@med.toho-u.ac.jp toho university nephrology tokyo Japan -
Hideyo Oguchi hideyo.oguchi@med.toho-u.ac.jp toho university nephrology tokyo Japan -
Yuko Hamasaki yuhamasaki@med.toho-u.ac.jp toho university nephrology tokyo Japan -
Ken Sakai kensakai@med.toho-u.ac.jp toho university nephrology tokyo Japan -
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Herpes zoster is a frequent complication after kidney transplantation. This study aimed to assess its incidence and associated risk factors in adult kidney transplant recipients.

We retrospectively reviewed cases of herpes zoster among 714 adult patients who had received outpatient care at the Kidney Center of Toho University Omori Medical Center between April, 2013 and March, 2023. Incidence rates were calculated per 1000 person-years. Patient characteristics were compared between those with and without herpes zoster. Multivariable logistic regression was used to identify independent risk factors. Patients with herpes zoster were categorized into disseminated and localized groups, and their clinical backgrounds were compared.

Herpes zoster occurred in 112 patients (15.7%), with an incidence of 22.1 per 1000 person-years. The median age at onset was 51 years, and the median time from transplantation to onset was 7.8 years. Age-specific incidence rates per 1000 person-years were 12.2 (twenties), 24.0 (thirties), 21.7 (forties), 23.9 (fifties), 25.8 (sixties), and 25.3 (≥seventies). Notably, elevated incidence was evident from the third decade onwards. Independent risk factors included reduced estimated glomerular filtration rate (OR 1.83, 95% CI: 1.20–2.81, p = 0.005)), and administration of rabbit anti-lymphocyte antibodies (OR 3.39, 95% CI: 1.52–7.32, p = 0.003). Among affected patients, 13 cases were disseminated, 94 were localized, and 5 were unclassified. While the difference did not reach statistical significance, disseminated herpes zoster cases were more frequently associated with anti-lymphocyte antibody use compared to the non-use group (27.3% vs. 8.7%, p = 0.059).

Herpes zoster was relatively common, even among younger adult kidney transplant recipients. Strong immunosuppression and impaired renal function may increase the risk of herpes zoster and its dissemination.

Kewords