Interesting. Does this mean that a patient with a zoster outbreak should be treated even after 72 hours has elapsed from initial onset of lesions with the goal of preventing vasculopathy?
Shingles May Portend Stroke, But Antivirals Lower Risk — Physician’s First Watch
Shingles May Portend Stroke, But Antivirals Lower Risk
By Joe Elia
The risk for stroke increases significantly in the weeks after the onset of herpes zoster, especially cases of zoster affecting the distribution of the trigeminal nerve, according to a Clinical Infectious Diseases study.
Using a U.K. general practice database, researchers studied some 6500 patients who had zoster and subsequent stroke. The observations began in the baseline period before the onset of zoster and extended for at least a year.
Patients were at greatest risk in the first 4 weeks after zoster onset, having an incidence ratio of 1.63 relative to baseline. The ratio in weeks 13 through 26 declined to 1.23, becoming nonsignificant thereafter. Stroke risks were especially strong after zoster ophthalmicus.
Roughly half the patients received oral antiviral treatment, and among those, there was a protective effect. The authors, suspecting a role for vasculopathy, encourage improvement in what they see as a relatively low rate of treatment with antivirals.