Effects of applying nerve blocks to prevent postherpetic neuralgia in patients with acute herpes zoster: a systematic review and meta-analysis

The incidence of herpes zoster (HZ) in patients infected with HIV is higher than that of the general population. However, the incidence of HZ in HIV patients receiving antiretroviral therapy (ART) remains unclear. This meta-analysis aimed to estimate the pooled incidence rate and risk factors for HZ in the post-ART era. We identified studies assessing the incidence of HZ in the post-ART era between 1 January 2000 and 28 February 2021, from four databases. Pooled risk ratios were calculated from 11 articles using a random-effects model. The heterogeneity of the included trials was evaluated by visually inspecting funnel plots, performing random-effects meta-regression and using I2 statistics. Of the 2111 studies screened, we identified 11 studies that were eligible for final inclusion in the systematic review and 8 studies that were eligible for a meta-analysis. The pooled incidence of HZ in the post-ART era (after the introduction of ART in 1997) was 2.30 (95% confidence interval (CI): 1.56–3.05) per 100 person years (PYs). The risks of incidence of HZ among people living with HIV included male sex (AOR: 4.35 (95% CI: 054–2.41)), men who have sex with men (AOR: 1.21 (95% CI: −0.76–1.13)), CD4 count < 200 cells/μL (AOR: 11.59 (95% CI: 0.53–4.38)) and not receiving ART (AOR: 2.89 (95% CI: −0.44–2.56)). The incidence of HZ is substantially lower among HIV infected patients receiving ART than those not receiving ART. Initiating ART immediately after diagnosis to treat all HIV-positive individuals is crucial to minimize the disease burden of HZ.

Download Full-text

Pharmacological and non-pharmacological strategies for preventing postherpetic neuralgia: a systematic review and network meta-analysis

The Korean Journal of Pain ◽

10.3344/kjp.2021.34.4.509 ◽

2021 ◽

Vol 34 (4) ◽

pp. 509-533

Author(s):

Junhyeok Kim ◽

Min Kyoung Kim ◽

Geun Joo Choi ◽

Hwa Yong Shin ◽

Beom Gyu Kim ◽

...

Keyword(s):

Systematic Review ◽

Postherpetic Neuralgia ◽

Meta Analysis

Download Full-text

Herpes zoster as a marker of occult cancer: A systematic review and meta-analysis

Journal of Infection ◽

10.1016/j.jinf.2016.11.005 ◽

2017 ◽

Vol 74 (3) ◽

pp. 215-235 ◽

Cited By ~ 12

Author(s):

S.A.J. Schmidt ◽

A. Mor ◽

H.C. Schønheyder ◽

H.T. Sørensen ◽

O.M. Dekkers ◽

...

Keyword(s):

Systematic Review ◽

Herpes Zoster ◽

Meta Analysis ◽

Occult Cancer

Download Full-text

Acute Herpes Zoster and Postherpetic Neuralgia

Pain Management ◽

10.1016/b978-1-4377-0721-2.00029-5 ◽

2011 ◽

pp. 268-271

Author(s):

Steven D. Waldman

Keyword(s):

Herpes Zoster ◽

Postherpetic Neuralgia ◽

Acute Herpes Zoster

Download Full-text

Biologics targeting type I interferons in SLE: A meta-analysis and systematic review of randomised controlled trials

Lupus ◽

10.1177/0961203320959702 ◽

2020 ◽

Vol 29 (14) ◽

pp. 1845-1853

Author(s):

Jeffery Wei Heng Koh ◽

Cheng Han Ng ◽

Sen Hee Tay

Keyword(s):

Systematic Review ◽

Herpes Zoster ◽

Lupus Erythematosus ◽

Viral Infections ◽

Meta Analysis ◽

Type I Interferons ◽

Type I ◽

Upper Respiratory Tract ◽

Type I Ifn ◽

Tract Infections

Objective The feed-forward loop of type I interferons (IFNs) production and subsequent immunopathology of systemic lupus erythematosus (SLE) has been hypothesised to be disrupted with inhibition of IFNα or type I IFN receptor subunit 1 (IFNAR). This systematic review and meta-analysis present the treatment efficacy and safety profile of monoclonal antibodies inhibiting IFNα or IFNAR. Methods A search was done using Medline, Embase and ClinicalTrials.gov for biologics targeting IFNα or IFNAR in SLE up to 3 Jan 2020. For the meta-analysis, analyses of binary variables were pooled using odds ratio (OR) with the Mantel Haenszel model. Results Anifrolumab 300 mg (n = 3 studies, 927 patients) was more effective than placebo in achieving SRI(4) (pooled OR = 1.91, CI 1.11-3.28, P = 0.02) and BICLA response (pooled OR = 2.25, CI 1.72-2.95, P < 0.00001). In SLE patients with high type I IFN gene signature, SRI(4) response was not achieved with anifrolumab in 2 studies, 450 patients. Treatment with IFNα and IFNAR inhibitors (n = 7 studies, 1590 patients) increased the risk of herpes zoster infection (pooled OR = 3.72, CI 1.88–7.39, P = 0.0002), upper respiratory tract infections, nasopharyngitis and bronchitis. Conclusion This meta-analysis substantiates IFNAR as a therapeutic target in SLE. Inhibition of type I IFNs predisposes to herpes zoster and other viral infections.

Download Full-text