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Kidney Week

Abstract: PO1583

Risk of Severe Herpes Zoster Infection in Patients with Polycystic Kidney Disease: A Nationwide Cohort Study with Propensity Score-Matching Analysis

Session Information

Category: Genetic Diseases of the Kidneys

  • 1001 Genetic Diseases of the Kidneys: Cystic

Author

  • Yu, Tung-Min, Taichung Veterans General Hospital, Taichung, Taiwan
Background

Polycystic kidney disease (PKD) should be considered as a systemic disorder rather than only a kidney disease. Significantly lower lymphocyte cell counts, including B and T lymphocyte counts, is noted in patients with PKD. This lymphopenia poses a risk of viral infection. Data to elucidate the herpes virus infection risk in patients with PKD are lacking; therefore, we conducted a national-wide population-based cohort study to investigate the herpes virus risk in PKD patients.

Methods

Patients who were hospitalized at least once with a diagnosis of autosomal dominant PKD were defined as PKD patients; patients without any diagnosis of PKD during the study period were grouped into the non-PKD cohort. The index date was set as the date when the patients were newly diagnosed with PKD. All study patients were followed up until the occurrence of herpes zoster infection, herpes simplex infection, death, withdrawal from the National Health Insurance Research Database for other reasons, or until December 31, 2013.

Results

We included 4358 PKD patients and 4358 non-PKD patients. The incidence rate and the risk of developing herpes zoster and herpes simplex were estimated using multivariate stratified analyses. PKD patients had an overall 2.43-fold risk of herpesvirus infection (aHR = 2.43, 95% CI 1.47–4.04) and 2.36-fold risk of herpes zoster (aHR = 2.36, 95% CI 1.34–4.13) in subgroup analysis compared with the non-PKD cohort. PKD patients without any comorbidities had a significantly higher risk of herpes zoster or herpes simplex (aHR = 3.38, 95% CI 1.51–7.56).

Conclusion

This is the first study to reveal the severe risk of herpes zoster infection in patients with PKD. High index suspicion of severe herpes zoster infection should be maintained in clinical professionals. Whether patients with PKD should be prophylactic universally with anti-varicella-zoster virus vaccine needs to be investigated in the future.