P1653 - Herpes Zoster Virus in Hospitalized Patients With Inflammatory Bowel Disease: A National Analysis of Disease Presentation and Age Distribution

Daniela Guerrero Vinsard, MD¹, Raffi Karagozian, MD², Dorothy Wakefield, MSc(Epi)³, Freddy Caldera, DO, MS⁴, Courtenay Ryan-Fisher, MBBCh⁵, Francis A. Farraye, MD, MSc^6
1Mayo Clinic, Rochester, MN; ²Tufts University Medical Center, Boston, MA; ³Saint Francis Hospital and Medical Center, Farmington, CT; ⁴University of Wisconsin Hospital and Clinics, Madison, WI; ⁵University of Connecticut, Farmington, CT; ⁶Mayo Clinic, Jacksonville, FL

Introduction: Several studies have demonstrated an increased risk of herpes zoster (HZ) in patients with inflammatory bowel disease (IBD). A previous USA inpatient cohort analysis showed that patients with IBD have twice the odds of admission to the hospital with HZ. Current ACG and ECCO guidelines on preventive care in IBD recommend that all patients over the age of 50 should consider vaccination against HZV. Our aim was to explore the occurrence of HZ and its complications in the inpatient IBD population and thereby allow a better understanding of the infection burden and age-specific prevalence.

Methods: Population-based cohort analysis using the 2014 USA National Inpatient Sample (NIS) ICD-9 codes. We measured the frequency of adult patients with Crohn's disease and ulcerative colitis, admitted to the hospital with HZ or any complication of HZ such as postherpetic neuralgia (PHN). Frequencies and demographics for HZV complications were determined and an age-stratification analysis performed.

Results: 307,260 patients were found to have IBD (63% CD and 37% UC). Shingles was more frequent in inpatients with IBD versus non-IBD inpatients (23% vs 14%, p< 0.0001). HZ with neurologic complications, ophthalmic complications and PHN were also more frequent in the IBD group (p=0.03, p=0.04 and p=0.02 respectively). The frequencies of complications from HZ subtypes were as follows: shingles 63%; PHN 26%; HZV with ophthalmic involvement including iridocyclitis, keratoconjunctivitis and ophthalmicus, 7%. HZ with neurologic involvement including meningitis, myelitis, geniculate, 4%.Women with IBD were more likely to have shingles (p=0.002)and PHN (p=0.001) than men with IBD but there was no difference in gender for non-shingles HZV involvement (p >0.05). The shingles distribution by age (p=0.0004) was 18-29 (8%), 30-39 (12%), 40-49 (29%), 50-59 (24%), 60-99 (30%). 83% of patients with IBD with shingles were >40 years old. Similarly, the likelihood of HZV ophthalmic complications and PHN appeared to be increased after age 50 while the likelihood of HZV neurologic complications decreased after age 39.

Discussion: HZ infection and its complications are more frequent in inpatients with IBD when compared to non-IBD inpatients. In the IBD cohort, shingles was the most frequent type of HZ infection/complication followed by PHN. Shingles is more frequent in women with IBD and its prevalence steadily increases with aging with the majority of cases found in patients over the age of 40.




Disclosures:


Daniela Guerrero Vinsard, MD¹, Raffi Karagozian, MD², Dorothy Wakefield, MSc(Epi)³, Freddy Caldera, DO, MS⁴, Courtenay Ryan-Fisher, MBBCh⁵, Francis A. Farraye, MD, MSc⁶. P1653 - Herpes Zoster Virus in Hospitalized Patients With Inflammatory Bowel Disease: A National Analysis of Disease Presentation and Age Distribution, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.