Patients with Cirrhosis at Higher Risk of Developing Shingles... Increased Risk of Hospitalization

Professor Choi Jong-ki's Team at Seoul Asan Hospital

A domestic research team has found that patients with liver cirrhosis have a higher incidence of herpes zoster.

Professor Choi Jong-gi of the Department of Gastroenterology at Seoul Asan Medical Center is examining a patient in their 30s with liver cirrhosis.
[Photo by Seoul Asan Medical Center]

Professor Choi Jong-gi's team from the Department of Gastroenterology at Seoul Asan Medical Center recently announced research results showing that patients with liver cirrhosis have higher incidence and hospitalization rates of herpes zoster compared to the general population. This study was published in the international journal American Journal of Gastroenterology (IF=12.045), issued by the American College of Gastroenterology.

Herpes zoster, characterized by multiple vesicles on the skin and severe pain, is known to occur mainly in elderly individuals, chronic disease patients, or those with weakened immunity due to immunosuppressant use. Until now, most studies on the association between liver cirrhosis and herpes zoster incidence were based on overseas data or small-scale studies, making it difficult to apply to domestic patients.

The research team analyzed the incidence of herpes zoster over an average of 6.5 years in 504,986 adult patients aged 20 or older who were newly diagnosed with liver cirrhosis between 2009 and 2015. Among the liver cirrhosis patients, a total of 70,294 developed herpes zoster between 2009 and 2019. The incidence rate of herpes zoster was 21.6 per 1,000 person-years, meaning that among 1,000 liver cirrhosis patients observed for one year, 21.6 developed herpes zoster. Hospitalizations due to herpes zoster were 1.81 per 1,000 person-years.

After adjusting for age, sex, and other factors, comparing liver cirrhosis patients with the general Korean population without liver cirrhosis, the risk of developing herpes zoster was approximately 9% higher in liver cirrhosis patients, and the risk of hospitalization due to herpes zoster was about 48% higher. Notably, young liver cirrhosis patients in their 20s had the highest risk of herpes zoster. The risk of herpes zoster in liver cirrhosis patients by age group increased by 41% in those in their 20s. Additionally, women, steroid or immunosuppressant users, and patients with decompensated liver cirrhosis accompanied by complications showed a higher risk of herpes zoster incidence.

Professor Choi said, "Liver cirrhosis is likely to cause immune dysfunction accompanied by decreased liver function, which makes herpes zoster more easily develop." He added, "Since this study targeted all adult liver cirrhosis patients in South Korea during the period, we hope it provides scientific evidence to recommend herpes zoster vaccination for liver cirrhosis patients."

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