Patients with chronic obstructive pulmonary disease (COPD) are at greater risk of shingles compared with the general population, according to a study published in CMAJ. The risk is greatest for patients taking oral steroids to treat COPD.

Shingles, or herpes zoster, is a reactivation of the chicken pox virus resulting in a painful rash with lesions.

People with a compromised immune system are at greater risk of developing shingles although it has not been previously studied in patients with COPD.

There is increasing evidence that COPD is an autoimmune disease. "Given that various immune-mediated diseases, such as rheumatoid arthritis and inflammatory bowel disease, have been reported to be associated with an increased risk of herpes zoster, it is reasonable to hypothesize that immune dysregulation found in COPD may put patients at higher risk of developing herpes zoster," writes Dr. Hui-Wen Lin, Taipei Medical University, Taiwan with coauthors.

This study, using data from the Taiwan Longitudinal Health Insurance Database, included 8486 patients with COPD and 33 944 subjects from the comparison cohort. Of the total sample of 42 430 patients, 1080 had incident of herpes zoster during the follow-up period. There were 321 cases of shingles identified in the COPD cohort, 16.4 per 1000 person years, and 759 cases in the comparison cohort, 8.8 per 1000 person years.

"Our cohort study demonstrated that patients with COPD are at an increased risk of developing herpes zoster compared with the general population, after controlling for other herpes zoster risk factors," write the authors. "The risk of herpes zoster associated with COPD is greater for patients with inhaled or oral corticosteroids therapy than patients without."

The authors conclude it is possible that "increased disease severity further contributes to the increased risk of herpes zoster associated with COPD."

Source: Canadian Medical Association Journal