Rheumatoid arthritis and herpes zoster: risk and prevention in those treated with anti-tumour necrosis factor therapy.

摘要

In this issue of Annals of Rheumatic Diseases, Garcia-Doval and colleagues add to a flurry of recent studies examining the risk and outcomes of herpes zoster (HZ) among those patients who use anti-tumour necrosis factor (TNF) therapies. While the increased risk of infection due to granulomatous and select other intracellular pathogens has been clearly demonstrated in this setting,1"3 much less is clear with regard to viral pathogens.4 The reactivation of varicella zoster virus (HZ or shingles) is of public health concern given HZ's ability to cause substantial long-term pain, depression and disability due to postherpetic neuralgia (PHN).4 5 HZ is common; approximately one-third of the population will experience it during their lifetime, with 18% of cases resulting in PHN and 10% to 15% involving ocular tissues with potential for permanent visual loss.