D2.96 - Frequency of Herpes Zoster in Asthma and Associated Factors

Shingles( Herpes Zoster) is a disease characterized by skin lesions resulting from the reactivation of Varicella Zoster Virus. Recent studies have emphasized that chronic airway diseases may be a risk factor for the development of zoster. The aim of our study is to investigate the frequency of herpes zoster in patients followed up in our asthma outpatient clinic and to determine its  relationship between asthma phenotypes, demographic characteristics and severity.

It was a cross-sectional study. A questionnaire prepared by the study group was applied to asthmatic patients who had been followed up in our clinic for at least one year, questioning their zoster history. Data on the patients' demographic characteristics, phenotypes, asthma control tests (ACT) and treatments they received were collected from patient files.

The study included 150 (F: 124/M: 26) asthma patients with a mean age of 52.63±13.43 and mean asthma duration of 17.55±11.89 years. 34.2% (n: 51) of the patients were atopic, 70.5% (n: 105) were eosinophilic, 70.5% (n: 105) were on step 4-5 treatment, and the mean ACT at the last visit was 20.38±4.29. Among the wholw group the rate of patients with zoster history was 16. No deterioration in asthma control was observed in the period in which zoster occurred (ACT: 22.2±3.70). When asthmatics with and without zona history   were compared, it was seen that the mean age of the patients with zoster was older, their asthma duration was longer and the rate of receiving step 1-2 treatment was higher [respectively: 59.71±10.39 vs. 51.29±13.56, (p=0.004); 22.67±12.69 vs. 17.55±11.89, (p=0.02); 12.5% ​​vs. 0.8%, (p=0.01)]. Emergency admission hospitalization and oral corticosteroid(OCS) use rates in the last one year were similar in both groups. Concomitant diseases such as Hypertension (HT), Diabetes Mellitus (DM) and Coranary Artery Disease (CAD) were more common in those who had zoster history compared to those who did not [respectively: 58.3% vs. 22.2%, (p=0.001); 29.2% vs. 7.9%, (p=0.007); 25% vs. 5.6%, (p=0.007)]. In 66.7% of those with zoster (n:16), the disease affected more than one area. Among subjects with zoster history 37.5% (n: 9) had postherpetic neuralgia, 55.6% of these patients were using high-dose Inhaled Corticosteroid (ICS) and the duration of zoster was longer than those without postherpetic neuralgia (11.67±6.65 weeks vs. 1.36±0.84 weeks, p<0.001). There was no association between postherpetic neuralgia and the use of OCS.

It was determined that the frequency of zoster in asthma patients followed in our clinic was consistent with the literature, and that it was more common in patients who had asthma for a longer period of time, were older, and had comorbidities such as HT, CAD, and DM.