A propensity score matching study on clinical characteristics and risk factors of herpes zoster in malignant tumor

Background: Herpes zoster (HZ) is caused by the reactivation of latent varicella-zoster virus (VZV). Cancer patients, due to immune suppression, are at an increased risk of HZ. However, the exact relationship between cancer and the occurrence of HZ remains unclear. Methods: This retrospective study collected data from cancer patients diagnosed between 01/01/2020, and 30/09/2024. Descriptive statistics were used to summarize the clinical characteristics of HZ patients. Propensity score matching (PSM) was applied to match HZ and non-HZ groups in a 1:3 ratio, controlling for potential confounding factors. Logistic regression analysis was performed to investigate the impact of cancer type, treatment modalities, and other factors on the occurrence of HZ. Results: Among 99 HZ patients, the onset of HZ was closely associated with the timing of anticancer treatment, with 89.89% of patients developing HZ within 12 months after the first anticancer therapy. After PSM matching, cancer type was identified as a significant independent risk factor for HZ. Patients with hematologic cancers, such as multiple myeloma, had a significantly higher risk of developing HZ compared to those with solid tumors (OR = 2.41, 95% CI 1.11-5.24, P = 0.03). Conclusions: Hematologic malignancy patients are at a significantly higher risk of developing HZ compared to those with solid tumors. The use of immune checkpoint inhibitors (ICIs) did not significantly increase the risk of HZ. These findings suggest that patients with hematologic cancers should be closely monitored for HZ and undergo preventive measures.