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Herpes zoster and the risk of ischemic and hemorrhagic stroke: A systematic review and meta-analysis

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  • Ying Lian
  • Yun Zhu
  • Fang Tang
  • Bing Yang
  • Ruisheng Duan

Abstract

Background: Herpes zoster infection and stroke are highly prevalent in the general population; however, reports have presented inconsistent findings regarding the relationship between herpes zoster infection and stroke. In this meta-analysis, we aimed to clarify this association. Material and methods: The PubMed and Embase databases were searched for studies published from their inception to January 2016. Two investigators independently extracted the data. The pooled relative risk (RR) was calculated using a random effects model. Results: A total of 8 studies met the inclusion criteria. During the first 1 month after herpes zoster infection, the pooled RRs for ischemic stroke and hemorrhagic stroke were 1.55 (95% CI, 1.46–1.65) and 1.70 (95% CI, 0.73–3.96), respectively, and within 3 months after infection, the corresponding RRs were 1.17 (95% CI, 1.12–1.23) and 2.05 (95% CI, 1.17–3.60), respectively. At 1 year and more than 1 year after herpes zoster infection, a significant relationship was not observed between herpes zoster infection and the incidence of ischemic and hemorrhagic stroke. Publication bias was not observed. Conclusion: The accumulated evidence generated from this systematic review indicates that an increased risk for ischemic stroke occurred in the short term after herpes zoster infection, whereas a significant relationship was not observed in the long term after infection. With respect to hemorrhagic stroke, the association was not significant. With respect to hemorrhagic stroke, the association between was not significant except within 3 months after a herpes zoster infection.

Suggested Citation

  • Ying Lian & Yun Zhu & Fang Tang & Bing Yang & Ruisheng Duan, 2017. "Herpes zoster and the risk of ischemic and hemorrhagic stroke: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-13, February.
    • Handle: RePEc:plo:pone00:0171182
    DOI: 10.1371/journal.pone.0171182
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    References listed on IDEAS

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    1. Sinéad M Langan & Liam Smeeth & David J Margolis & Sara L Thomas, 2013. "Herpes Zoster Vaccine Effectiveness against Incident Herpes Zoster and Post-herpetic Neuralgia in an Older US Population: A Cohort Study," PLOS Medicine, Public Library of Science, vol. 10(4), pages 1-11, April.
    2. Alessandro Liberati & Douglas G Altman & Jennifer Tetzlaff & Cynthia Mulrow & Peter C Gøtzsche & John P A Ioannidis & Mike Clarke & P J Devereaux & Jos Kleijnen & David Moher, 2009. "The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-28, July.
    3. Caroline Minassian & Sara L Thomas & Liam Smeeth & Ian Douglas & Ruth Brauer & Sinéad M Langan, 2015. "Acute Cardiovascular Events after Herpes Zoster: A Self-Controlled Case Series Analysis in Vaccinated and Unvaccinated Older Residents of the United States," PLOS Medicine, Public Library of Science, vol. 12(12), pages 1-15, December.
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    1. Ji Eun Park & Tae Young Kim & Yun Jung Jung & Changho Han & Chan Min Park & Joo Hun Park & Kwang Joo Park & Dukyong Yoon & Wou Young Chung, 2021. "Biosignal-Based Digital Biomarkers for Prediction of Ventilator Weaning Success," IJERPH, MDPI, vol. 18(17), pages 1-17, September.
    2. LM Dennis & K Badger & R Mizoguchi, 2019. "Herpes Zoster Cerebral Vasculopathy in a Case of Cognitive Decline," Biomedical Journal of Scientific & Technical Research, Biomedical Research Network+, LLC, vol. 20(1), pages 14751-14753, July.
    3. Nathaniel Erskine & Hoang Tran & Leonard Levin & Christine Ulbricht & Joyce Fingeroth & Catarina Kiefe & Robert J Goldberg & Sonal Singh, 2017. "A systematic review and meta-analysis on herpes zoster and the risk of cardiac and cerebrovascular events," PLOS ONE, Public Library of Science, vol. 12(7), pages 1-18, July.

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