Abstract Background/Aims Herpes zoster (HZ) is more common and severe in immunocompromised than immunocompetent individuals. Data on HZ incidence are limited in patients with autoimmune disease (AID) and robust up-to-date evidence is required to help better understand HZ incidence in this population. Methods A retrospective cohort study was conducted in adults aged ≥18 years in England using a large data source (Clinical Practice Research Datalink CPRD with linkage to Hospital Episodes Statistics HES). Adults aged ≥18 years with a CPRD-HES database record indicating any of the following immunocompromising conditions (ICs) of interest were identified between 2012 and 2018, and followed up until 31-Dec-2019: AID (autoimmune thyroiditis AT, inflammatory bowel disease IBD, multiple sclerosis MS, polymyalgia rheumatica PR, psoriasis/psoriatic arthritis P/PsA, rheumatoid arthritis RA, systemic lupus erythematosus SLE), haematological malignancies, haematopoietic stem cell transplantation, solid organ transplant/malignancies and human immunodeficiency virus. Adults without any ICs of interest (IC-free) were also identified and followed during the same period. Overall HZ incidence rates (IRs) were estimated per 1,000 person-years (PY) with 95% confidence intervals (CI), and by age and first IC. We present HZ IRs in adults with AID and in IC-free adults. Results A total of 1,764,900 immunocompromised and 12,867,750 IC-free adults were identified. Among immunocompromised adults, 56.64% had at least one AID reported (mean age: 52.22 years standard deviation: 18.63, 58.53% female). During follow-up, 3.02% (n = 30,181) of AID adults developed HZ. Among those, 97.80% (n = 29,516) had undergone/were undergoing immune-suppressing treatments. HZ IRs were higher in AID adults than in IC-free adults and increased with age (Table 1). The overall HZ IR in AID adults was 6.64/1,000 PY and increased from 3.08 in adults aged 18-49 years to 13.20 in adults aged ≥80 years (Table 1). HZ IRs varied by AID (PR: 12.15; SLE: 10.19; RA: 7.84; MS: 6.99; IBD: 6.92; AT: 6.03; P/PsA: 5.05). In AID adults aged 18-49 years, the highest HZ IRs were seen in those with SLE (7.98). Conclusion This study highlights that HZ substantially affects adults with AID, including younger adults. Researchers, clinicians and decision makers could use this knowledge to inform further HZ research, guidelines, and immunisation recommendations. Disclosure A. Mahmood: Shareholder/stock ownership; Holds financial equities in GSK. Other; GSK employee, Member of the board of trustees for a mental health charity, Beyond Conflict (registered charity number: 1176499) – voluntary (unpaid). C. O’Reilly: Shareholder/stock ownership; Holds financial equities in GSK, Holds financial equities in Pfizer. Other; GSK employee. M. Nishimwe: Shareholder/stock ownership; Holds financial equities in GSK. Other; GSK employee. Y. Vekria: Shareholder/stock ownership; Holds financial equities in GSK, Holds financial equities in Haleon. Other; GSK employee. M. Hunjan: Shareholder/stock ownership; Holds financial equities in GSK, Holds financial equities in Haleon. Other; Manjit Hunjan was a GSK employee during study conception, design and execution. K. Keapoletswe: Other; IQVIA Ltd. employee. D. Oraichi: Shareholder/stock ownership; Holds financial equities in GSK. Other; GSK employee. S. Paparrodopoulos: Other; IQVIA Ltd. employee. S. Stavrev: Other; IQVIA Ltd. employee. L. Cirneanu: Other; IQVIA Ltd. employee. L. Raiteri: Other; IQVIA Ltd. employee. S. Lay-Flurrie: Other; IQVIA Ltd. employee. I. Posiuniene: Shareholder/stock ownership; Holds financial equities in GSK, Holds financial equities in Haleon. Other; GSK employee, Declares travel support from GSK. S. Farrow: Shareholder/stock ownership; Holds financial equities in GSK, Holds financial equities in Sanofi, Holds financial equities in Organon. Other; GSK employee. B. Guimicheva: Shareholder/stock ownership; Holds financial equities in GSK, Holds financial equities in MSD. Other; GSK employee. A. Marijam: Shareholder/stock ownership; Holds financial equities in GSK. Other; GSK employee.
Mahmood et al. (Wed,) studied this question.
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