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Balanitis is a risk factor for herpes zoster

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Abstract

Both balanitis and herpes zoster (HZ) may be influenced by the immune system. The objective of this study was to investigate the association between balanitis and HZ. We selected patients aged 20 years and older who were newly diagnosed with balanitis from 2000 to 2010 through the Longitudinal Health Insurance Database 2000. The non-balanitis cohort consisted of randomly selected patients who were matched to the balanitis cohort by age. Distributions of age and comorbidities were compared between the balanitis and non-balanitis cohorts; the categorical variables were examined using a Chi-squared test and the continuous variables were examined using a t-test. Univariable and multivariable Cox proportional hazards regression models were used to estimate the hazard ratios and 95 % confidence intervals for HZ among the balanitis patients in relation to the non-balanitis patients. We identified 4,028 patients with balanitis who were matched based on age with 16,112 patients without balanitis. By the end of the 12-year follow-up, the patients with balanitis had a significantly higher cumulative incidence of HZ than the non-balanitis patients. The risk of HZ for patients without comorbidities was 1.54-fold higher in the balanitis cohort than in the non-balanitis cohort. The higher risk of HZ occurred during the first 6 years of follow-up after a diagnosis of balanitis. Balanitis is a risk factor for HZ. Men with balanitis have a higher risk of developing HZ. HZ vaccination might be necessary for men with balanitis.

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References

  1. Fakjian N, Hunter S, Cole GW, Miller J (1990) An argument for circumcision. Prevention of balanitis in the adult. Arch Dermatol 126:1046–1047

    Article  CAS  PubMed  Google Scholar 

  2. Hirji I, Andersson SW, Guo Z, Hammar N, Gomez-Caminero A (2012) Incidence of genital infection among patients with type 2 diabetes in the UK General Practice Research Database. J Diabetes Complications 26:501–505

    Article  PubMed  Google Scholar 

  3. Hinchliffe SA, Ciftci AO, Khine MM et al (1994) Composition of the inflammatory infiltrate in pediatric penile lichen sclerosus et atrophicus (balanitis xerotica obliterans): a prospective, comparative immunophenotyping study. Pediatr Pathol 14:223–233

    Article  CAS  PubMed  Google Scholar 

  4. Kawai K, Gebremeskel BG, Acosta CJ (2014) Systematic review of incidence and complications of herpes zoster: towards a global perspective. BMJ Open 4:e004833

    Article  PubMed Central  PubMed  Google Scholar 

  5. Weitzman D, Shavit O, Stein M, Cohen R, Chodick G, Shalev V (2013) A population based study of the epidemiology of herpes zoster and its complications. J Infect 67:463–469

    Article  PubMed  Google Scholar 

  6. Ultsch B, Köster I, Reinhold T et al (2013) Epidemiology and cost of herpes zoster and postherpetic neuralgia in Germany. Eur J Health Econ 14:1015–1026

    Article  PubMed  Google Scholar 

  7. Cebrián-Cuenca AM, Díez-Domingo J, Rodríguez MS, Puig-Barberá J, Navarro-Pérez J (2010) Epidemiology of herpes zoster infection among patients treated in primary care centres in the Valencian community (Spain). BMC Fam Pract 11:33

    Article  PubMed Central  PubMed  Google Scholar 

  8. Toyama N, Shiraki K (2009) Epidemiology of herpes zoster and its relationship to varicella in Japan: A 10-year survey of 48,388 herpes zoster cases in Miyazaki prefecture. J Med Virol 81:2053–2058

    Article  PubMed  Google Scholar 

  9. Gauthier A, Breuer J, Carrington D, Martin M, Rémy V (2009) Epidemiology and cost of herpes zoster and post-herpetic neuralgia in the United Kingdom. Epidemiol Infect 137:38–47

    Article  CAS  PubMed  Google Scholar 

  10. Lin YH, Huang LM, Chang IS et al (2010) Disease burden and epidemiology of herpes zoster in pre-vaccine Taiwan. Vaccine 28:1217–1220

    Article  PubMed  Google Scholar 

  11. Toussaint RL (1993) Tale of a ‘dicky’ heart. Aust Fam Physician 22:924–925

    CAS  PubMed  Google Scholar 

  12. Wozniak KD, Bär M (1990) Significance of skin changes in diabetes mellitus. Z Gesamte Inn Med 45:669–673

    CAS  PubMed  Google Scholar 

  13. Østergaard K, Damgaard M, Kristiansen TB, Madsen KG (2009) Herpes zoster incidence in persons above 50 years of age. Ugeskr Laeger 171:2194–2197

    PubMed  Google Scholar 

  14. Pinchinat S, Cebrián-Cuenca AM, Bricout H, Johnson RW (2013) Similar herpes zoster incidence across Europe: results from a systematic literature review. BMC Infect Dis 13:170

    Article  PubMed Central  PubMed  Google Scholar 

  15. Schmader K, George LK, Burchett BM, Hamilton JD, Pieper CF (1998) Race and stress in the incidence of herpes zoster in older adults. J Am Geriatr Soc 46:973–977

    CAS  PubMed  Google Scholar 

  16. Lasserre A, Blaizeau F, Gorwood P et al (2012) Herpes zoster: family history and psychological stress—case–control study. J Clin Virol 55:153–157

    Article  PubMed  Google Scholar 

  17. Mehta SK, Cohrs RJ, Forghani B, Zerbe G, Gilden DH, Pierson DL (2004) Stress-induced subclinical reactivation of varicella zoster virus in astronauts. J Med Virol 72:174–179

    Article  PubMed  Google Scholar 

  18. Schmader K, Studenski S, MacMillan J, Grufferman S, Cohen HJ (1990) Are stressful life events risk factors for herpes zoster? J Am Geriatr Soc 38:1188–1194

    CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by grants from China Medical University (CMU102-BC-2), Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW103-TDU-B-212-113002), Health and Welfare Surcharges of tobacco products, and China Medical University Hospital Cancer Research Center of Excellence (MOHW104-TD-B-111-03, Taiwan). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding was received for this study.

Conflict of interest

The authors have no conflicts of interest.

Author contributions

All authors have contributed substantially to, and are in agreement with the content of, the manuscript: conception/design: Chao-Yu Hsu, Chia-Hung Kao; provision of study materials: Chia-Hung Kao; collection and/or assembly of data: all authors; data analysis and interpretation: all authors; manuscript preparation: all authors; final approval of manuscript: all authors. The guarantor of the paper, taking responsibility for the integrity of the work as a whole, from inception to published article: Chia-Hung Kao.

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Authors and Affiliations

  1. Department of Medical Education and Research, Puli Christian Hospital, Puli, Taiwan

    C.-Y. Hsu

  2. Department of Optometry, Central Taiwan University of Science and Technology, Taichung, Taiwan

    C.-Y. Hsu

  3. Center for General Education, National Taichung University of Science and Technology, Taichung, Taiwan

    C.-Y. Hsu

  4. The General Education Center, Chaoyang University of Technology, Taichung, Taiwan

    C.-Y. Hsu

  5. Department of General Education, National Chin-Yi University of Technology, Taichung, Taiwan

    C.-Y. Hsu

  6. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

    C.-L. Lin

  7. College of Medicine, China Medical University, Taichung, Taiwan

    C.-L. Lin

  8. Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 404, Taiwan

    C.-H. Kao

  9. Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan

    C.-H. Kao

Authors
  1. C.-Y. Hsu
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  2. C.-L. Lin
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  3. C.-H. Kao
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Corresponding author

Correspondence to C.-H. Kao.

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Hsu, CY., Lin, CL. & Kao, CH. Balanitis is a risk factor for herpes zoster. Eur J Clin Microbiol Infect Dis 34, 985–990 (2015). https://doi.org/10.1007/s10096-015-2314-0

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  • DOI: https://doi.org/10.1007/s10096-015-2314-0

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