Abstract
Purpose:
Herpes zoster ophthalmicus (HZO) has an estimated incidence of 1.5 to 6.4 cases per 100,000 persons per year in the general population. The purpose of this retrospective case-control study is to examine the risk of developing HZO among patients who are positive for human immunodeficiency virus (HIV), and among patients with history of atopic disease.
Methods:
This study utilized hospital-based controls for the study period from May 1, 2006 to May 31, 2014. Inclusion criteria involved Bronx residents diagnosed with new-onset HZO during the eight-year study period at Montefiore Medical Center. Hospital-based controls were drawn from unique outpatients visits at Montefiore Medical Center during the study period. Controls were chosen randomly in a 4:1 ratio and were time-matched to HZO cases. Medical records were reviewed to confirm inclusion criteria and the data were used to calculate odds ratios for developing HZO in HIV-positive patients and in patients with history of atopic disease.
Results:
170 patients were diagnosed with new-onset HZO during the study period. Compared to hospital-based controls (n=680), HIV infection was shown to increase the odds of HZO by 6.63 (95% CI 2.96-14.8, p<0.001), and history of atopic disease was shown to increase the odds of HZO by 2.55 (95% CI 1.50-4.37, p=0.001).
Conclusions:
Infection with HIV and history of atopic disease are significant risk factors for having a new-onset case of HZO. This is a particularly important association in the Bronx, where the prevalence of HIV infection is over 3.6 times greater than in the United States overall.