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Rheum Dis Clin North Am. 2017 Feb;43(1):111-121. doi: 10.1016/j.rdc.2016.09.010. Epub 2016 Oct 22.

Incidence and Prevention of Herpes Zoster Reactivation in Patients with Autoimmune Diseases.

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Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, 825 Northeast 13th Street, Oklahoma City, OK 73104, USA. Electronic address:


Herpes zoster is the reactivation of latent varicella zoster virus usually occurring decades after initial exposure, and manifesting as a painful vesicular rash occurring along one or more dermatomes. Zoster incidence increases with age as cell mediated immunity against latent virus wanes. Epidemiological evidence suggests that individuals with underlying rheumatic diseases are at increased risk for zoster. It remains unclear whether this is due to immunosuppressive medications or from immune dysregulation of the underlying disease. A vaccine against zoster is available for individuals 50 years and older. Theoretical risks remain about using this live-attenuated virus vaccine in immunosuppressed individuals.


Autoimmune disease; Herpes zoster; Immunosuppression; Reactivation; Rheumatoid arthritis; Systemic lupus erythematosus; Vaccine; Varicella zoster virus

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