629. Family History as a Risk Factor for Herpes Zoster
Session: Poster Abstract Session: Oh, Those Pesky Viruses!
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • IDWEEK 2016_Family History as a Risk Factor for Herpes Zoster FINAL.pdf (167.9 kB)
  • Background:

    Both wild-type varicella zoster virus (WT-VZV) and varicella vaccine-strain VZV (VS-VZV) can reactivate to cause herpes zoster (HZ), although the risk from VZ-VZV appears to be low. Risk factors for HZ are older age and immunosuppression, but most HZ episodes occur in individuals with neither risk factor. Several studies suggest that HZ is associated with a family history of HZ; all have relied on self-report and were subject to recall bias. We used a large administrative database to assess the role of medically-attended HZ as a risk factor for HZ in family members.

    Methods:

    We conducted a retrospective cohort study using 1998-2014 medical claims data from Truven Health MarketScan® Commercial Databases. We defined HZ using ICD-9 codes, varicella vaccination using CPT codes, families as insurance co-beneficiaries, and family history based on whether or not the oldest child (i.e., index) experienced HZ. To assess HZ risk in siblings, families were restricted to those with ≥2 children, and HZ risk was assessed in second oldest child. To assess risk in parents, families were restricted to those with ≥1 children. We conducted separate analyses for families in which all the assessed children were latently infected with VS-VZV (i.e., prior varicella vaccine) and those in which all assessed children were infected with WT-VZV (i.e., without codes for varicella vaccine). Relative risks (RR) with corresponding 95% confidence interval and p-values were calculated.

    Results:

    Of the 59,920 families with children having WT-VZV, the RR of HZ for siblings was 28.5 (95% CI, 4.1, 198.0, p = 0.03); for parents the RR was 6.5 (95% CI, 5.0, 8.5, p < .0001). Among 181,579 families with VZ-VZV, the RR of HZ for siblings was 12.6 (95% CI, 4.8, 33.5, p < .0001); for parents the RR was 2.1 (95% CI, 1.7, 2.6, p < .0001).

    Conclusion:

    We used a large administrative database to assess the role of medically-attended HZ as a risk factor for HZ in family members. We found that family history of HZ was associated with HZ risk, both for siblings and for parents, and that the magnitude of risk was impacted by whether the index child was infected with WT-VZV or VS-VZV.

    Rebecca Dahl, MPH and Rafael Harpaz, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA

    Disclosures:

    R. Dahl, None

    R. Harpaz, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.