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J Clin Virol. 2011 Dec;52(4):344-8. doi: 10.1016/j.jcv.2011.08.014. Epub 2011 Sep 15.

Family history and herpes zoster risk in the era of shingles vaccination.

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University of Texas School of Medicine at San Antonio, San Antonio, TX, USA.



Herpes zoster is a common mucocutaneous infection caused by reactivation of latent varicella zoster virus previously introduced during a varicella infection. The epidemiology of the disease has changed since the approval of Zostavax(®) and the risk factors have been studied in depth.


To further assess the possibility of family history as a risk factor for herpes zoster, determine the age of herpes zoster onset and the rate of recurrence.


A case-control study involved 1103 acute herpes zoster patients and 523 controls.


Case patients were more likely to report blood relatives with a history of herpes zoster than controls (43.5% vs. 10.5%; P<0.001) (odds ratio for first-degree relatives, 4.44; 95% confidence interval 3.11-6.35). A dose-dependent effect was documented; risk was increased with multiple blood relatives (odds ratio, 17.15; 95% confidence interval, 7.50-39.18) compared with single blood relatives (odds ratio, 5.24; 95% confidence interval, 3.79-7.23). The mean age of herpes zoster onset was 51.7 (SD 19.0) years and the recurrence rate was 9.3%.


The results indicate a stronger association between herpes zoster and family history of herpes zoster than previously reported in the literature and suggest a genetic predisposition to herpes zoster may be more frequently inherited along maternal lines. A lower mean age of herpes zoster onset than previously documented in the literature is reported, which has implications for vaccine timing.

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