COPD Patients May Have Risk of Shingles

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Feb. 24, 2011 — People with chronic obstructive pulmonary disease (COPD) may be at increased risk for developing shingles, a new study shows.

Shingles occurs when the varicella zoster virus, which causes chickenpox, is reactivated. COPD is the umbrella term for a group of progressive, debilitating lung diseases such as chronic bronchitis and emphysema. COPD is the fourth leading cause of death in the U.S., according to the American Lung Association.

COPD is often associated with smoking, but a growing body of evidence suggests that it may be autoimmune in nature, according to the study researchers. Autoimmune diseases occur when the body’s immune system attacks its own healthy organs and tissues, such as the lungs.

“Our results suggest that COPD, like other inflammatory diseases (e.g. rheumatoid arthritis, inflammatory bowel disease) was associated with an increased risk of herpes zoster [shingles] relative to that in the general population,” conclude researchers who were led by Ya-Wen Yang, MD, of the Taipei Medical University in Taiwan. “To prevent the substantial morbidity ensuing form this vexing disease, it is recommend that patients with COPD receive zoster vaccination in addition to influenza and pneumococcal immunization.”

The study is published in the Canadian Medical Association Journal.

COPD and Shingles

The new study included 8,486 people with COPD and 33,944 COPD-free people who made up a comparison group. A total of 1,080 people developed shingles, including 321 people with COPD.

Overall, people with COPD were 68% more likely to develop shingles than those without COPD. This risk was higher among people with COPD who were taking inhaled or oral steroids to treat the disease. Steroids can suppress the immune system and leave individuals more prone to infections such as shingles.

The new findings reflect what Len Horovitz, MD, a pulmonary specialist at Lenox Hill Hospital in New York City, has noticed in practice. “COPD is partially an autoimmune disease in that there is a genetic susceptibility, and then an environmental factor like smoking brings this genetic susceptibility out big time,” he says.

Still, nonsmokers also can develop COPD. “Many people think COPD and smoking are hand-in-glove, but that is not the case,” Horovitz says.

People aged 62 and over with COPD should get the shingles shot in addition to their other yearly vaccinations to make sure they are protected, he says.

Neil Schachter, MD, professor of pulmonary medicine at Mount Sinai School of Medicine in New York City, points out that older, sicker people — including those with COPD — are more prone to shingles.

“Patients with COPD are at risk for many different diseases including diabetes, osteoporosis, and many other illnesses that might weaken you in other ways and make you more susceptible to developing shingles,” he says.

Still, he says “this is an interesting finding with practical value. These people should be watched for herpes zoster [shingles], but the reason they are at high risk is not fully understood at this point.”

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