2023-05-25 14:52:31
“Herpes zoster has an incidence of about 8 cases per thousand inhabitants per year, which increases with age, so much so that at 80 there is a 50% greater chance of incurring this pathology. It involves an annoying acute phase and sequelae, the best known being post-herpetic neuralgia, pain that affects the area where the infection has occurred and which persists for months”. However, “recent studies also highlight cardio and cerebro-vascular complications”. Thus Alessandro Rossi, head of acute pathologies of the Italian Society of General Medicine (Simg), speaking at the press conference entitled “Herpes Zoster and cardiovascular risk”, promoted today in Rome with the non-conditioning contribution of Gsk.
According to Rossi, there is a close relationship between this viral infection and “an inflammatory mechanism at the arterial vascular level”. The “variety and seriousness of these consequences – he continues – lead us to strongly recommend prevention, which can be implemented thanks to vaccination. In particular, an adjuvanted recombinant vaccine is available, which has demonstrated a clearly favorable risk/benefit ratio, as well as a persistence of effect over time, which reaches 10 years. Furthermore, this vaccine can also be administered in immunocompromised patients, who are most exposed to the infection together with the elderly and the chronically ill and therefore represent the most suitable recipients for the administration of the vaccination”.
Among the most significant studies that have found the relationship between Herpes zoster and the risk of cardiovascular events such as stroke and heart attack – reports a note – are those of the Universities of Harvard and Buffalo: they reported risk estimates relating to the onset of post- herpetic in specific time windows. The data produced was the object of attention by the Health Search research institute of Simg, which was able to analyze for the first time the month-to-month variation of the risk of stroke in those who suffer from the disease.
“American studies identify specific time windows in which the zoster-stroke relationship exhibits the maximum strength of association – underlines Francesco Lapi, Director of Health Search Research, Simg Research Institute of Florence – and the risk is twice higher than in subjects who do not have the disease in the first month after infection. It remains present up to 12 years after infection, although its weight is progressively decreasing. In the 9-12 year window, the risk of stroke in those who have had herpes zoster remains higher than 28%”.
The data from the Simg research institute “certify that in the first 6 years of the infection there are two peaks of a 30% increase in the risk of stroke compared to those who do not have the disease – adds Lapi – one in the first year of the infection and one in the sixth year. In the time interval between these two peaks there is a reduction in risk, but the significance of the correlation is maintained. Then the trend decreases over time, up to the 12th-13th year after the infection. Only then does it lose its significance. These data show that not only is vaccination important to avoid infection, but also to significantly reduce the risk of these complications and to be protected from them for a long time”.
Among the categories at risk for which anti zoster is particularly recommended are people with diabetes. “Diabetes is a disease with a high social-health impact, the incidence of which is increasing in all Western countries – recalls Rossi – Furthermore, it causes an increase in cardiovascular risk. We must be aware that the diabetic patient has a 30% higher risk of incurring Herpes zoster disease than the general population, especially if affected by comorbidities, including heart failure. In the light of recent studies that detect cardiovascular complications of zoster infection up to 12-13 years after the onset of the same, one can guess the further high risk of these patients. Hence the importance of vaccination in the populations concerned, in particular in subjects with chronic diseases”. And on the importance of this vaccination and the attention to be paid to the subjects to whom it should be administered as a priority, “Simg is working on a booklet in paper and digital format, which will soon be offered as a guide tool to all family doctors on the national territory,” he concludes.
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