Incidence and risk factors of herpes zoster infection in pediatric systemic lupus erythematosus
Authors' conclusion
The prevalence and incidence of HZ in cSLE patients are 15.72% and 38.40 per 100 person-years, respectively. The risk factors identified for HZ among cSLE patients were lymphopenia, lupus nephritis, and immunosuppressive agents. Glucocorticoid dosage ≥ 5 mg, azathioprine, and intravenous cyclophosphamide significantly predict the likelihood of developing HZ.
Study context
- Population
- Patients less than 19 years old with systemic lupus erythematosus (SLE) (cSLE) at a tertiary hospital in the Philippines
- Participants
- 388 participants
- Outcome
- Risk factors for HZ in patients with cSLE
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
HZ in cSLE: prevalence, incidence and risk factors
- Prevalence of herpes zoster (HZ)
- 15.72%
- Incidence rate of HZ (per 100 person-years)
- 38.40
- IV CYC: increased risk of HZ (times)
- 1.61 (p = 0.048)
- AZA: increased risk of HZ (times)
- 2.07 (p = 0.009)
- GC dose ≥ 5 mg: increased risk of HZ (times)
- 10.20 (p = 0.001)
Observational data: associations, not effects.
Further findings
Renal manifestations, with HZ vs without HZ
- Proportion with renal manifestations significantly higher among those with HZ
- 54.10% vs. 40.37%
HZ characteristics
- Most common location: upper extremities
- 18.03%
- Median SLEDAI at HZ diagnosis
- 4
- Recurrent HZ
- 16.39%
- Superimposed bacterial infection
- 11.48%
- Treated with acyclovir or valacyclovir
- 88.52%
Original publication
Incidence and risk factors of herpes zoster infection in pediatric systemic lupus erythematosus. Pediatr Rheumatol Online J. Published 30 October 2025. doi:10.
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