Herpes zoster: Family history and psychological stress—Case–control study
Section snippets
Study design
A case–control study was carried out in ambulatory adults in France between April 2009 and September 2010. Patients were recruited by general practitioners (GPs) belonging to the French ‘Sentinel's network’ (FSN). The FSN is a computerised system of volunteer GPs located throughout France, participating in the ongoing surveillance of 10 health indicators (including varicella and herpes zoster) as well as in ad-hoc epidemiological studies.13 The characteristics of the GPs of the FSN are
Results
Complete data were obtained from 250 cases and their 500 matched controls. The median age of cases was 67 years (range: 50–91 years), and the mean age difference between cases and their matched controls was 147 days. Amongst the included patients, 59% were female and 41% were male. There was no particular temporal trend of incidences associated with zoster in any month of the year amongst the 250 patients.
Discussion
The present study assessed risk factors for HZ in patients aged 50 years or older consulting a GP in France. A family history of HZ, depression, and a negative life event in the past 6 months were the variables retained in the final model, adjusted for age and sex.
Psychological stress and depression have been identified as potential risk factors for zoster that might operate by suppressing cell-mediated immunity, but controversy persists.7 Stressful life events have been shown to be risk factors
Funding
This work was co-constructed between INSERM and Sanofi-Pasteur MSD, who co-financed the study.
Competing interests
The authors do not have potential conflict of interest to declare. When the present work was done: A. Lasserre, PhD, was employee of Université Pierre et Marie Curie, Paris, France; F. Blaizeau, was employee of Université Pierre et Marie Curie, Paris, France; P. Gorwood, MD, was employee of the Hôpital Sainte Anne, Paris, France; K. Bloch, MD, was employee of Sanofi-Pasteur MSD, Lyon, France; P. Chauvin, MD, PhD, was employee of the INSERM, Paris, France; F. Liard, MD, is a general practitioner
Ethical approval
As it was stated by the French authorities (Comité de Protection des Personnes, Ile de France V, Paris), ethical approval was not necessary for this study. Two authorizations were obtained to recover and storage data related with this study: CNIL 091966, and CCTIRS 9291.
Acknowledgements
We thank all individuals who agreed to take part in the study, and the participating general practitioners belonging to the Sentinel network. This work was supported by a research grant co-funded by INSERM (Institut National de la Santé et de la recherché Médical) and Sanofi-Pasteur MSD.
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2018, International Journal of Infectious DiseasesCitation Excerpt :The median age of the cases in the study was 67 years. About 37% of the cases and 20.4% of the controls reported having at least one relative with a history of HZ (Lasserre et al., 2012). On the other hand, Gatti et al., who used PHN cases in their study, reported no evidence of family history as a risk factor for HZ, as a considerable proportion of the cases (28.4%) and a similar percentage of the controls (29.6%) reported a family history of HZ.