Description: Clinical Infectious Diseases publishes clinically relevant articles on the pathogenesis, clinical investigation, medical microbiology, diagnosis, immune mechanisms, and treatment of diseases caused by infectious agents. We used propensity score matching to ensure similarity between users and nonusers of statins, and Cox proportional hazard models to assess differences in outcomes between study groups. The magnitude of the risk associated to type II diabetes is conditioned by the age of the individual and the presence of comorbidities: it was highest in type II diabetics 65 years or older, who had a three-fold increased risk of developing HZ compared to non-diabetics. Studies were included if they reported the incidence of HZ, respectively, in patients receiving anti-TNF and conventional DMARDs. It substantially reduced outbreak frequency. Moving walls are generally represented in years. In a prespecified analysis, we found a similar risk of herpes zoster among statin users in the subgroup of patients with diabetes (HR, 1.18; 95% CI, 1.09-1.27).
These studies, as ours, were designed to assess the association between HZ and diabetes. CONCLUSIONS: This meta-analysis revealed a significantly increased risk of HZ, up to 61%, in patients with IRD receiving TNF blockers. At any given hospital the number of neonatal herpes infections is relatively low. Absorbed: Journals that are combined with another title. Furthermore, those studies that do exist were not highly powered. In a prospective matched case–control study Lasserre et al. Interestingly, the largest study examining the question of c-section efficacy found that symptomatic women were less likely to have infants with neonatal herpes.
That said, c-sections alone will not completely prevent neonatal herpes transmission. Several smaller studies have seen cases where neonatal herpes occurred after a c-section. That may be more likely if a woman’s water breaks a long time before she gives birth. This study did not observe a difference of anti-VZV antibody titer in patients with diabetes and healthy volunteers. That may encourage some women to seek out other options. Current ACOG guidelines state that c-sections are indicated for women with active herpes infections or prodromal symptoms at the time of delivery. However, they are not recommended for women who have a history of herpes but are not in the middle of an outbreak.
Herpes and childbirth are two highly emotionally charged issues. The same study found coronary diseases to modestly increase the risk of HZ (1.17, 95 % CI 1.11–1.22). Evidence suggests that women with long-established, asymptomatic genital herpes infections have a very low risk of neonatal herpes. They don’t need to let their childbirth choices be dictated by the virus. The case is more complex for women who became infected with herpes late during their pregnancy, or who experience regular outbreaks. In both circumstances, women have two options they can use to reduce their infant’s risk of neonatal herpes – suppressive therapy and c-sections. A review of HZ epidemiology in Europe showed that incidence rates are systematically higher among women than men (male/female ratio around 1.4), and this difference increased with age .
However, results are clearer for women with recurrent infections than those with primary infections. That’s true despite the differences in their absolute risk. This is, at least in part, because there are substantially fewer women who are diagnosed with a primary herpes infection during pregnancy. That makes interventions difficult to research. Another potential explanation is the role of a biological mechanism by which women would be more susceptible to VZV reactivation. However,, it is certainly not the choice for everyone. Circumstances will vary.
Women should not hesitate to discuss the pros and cons of all available options with their doctors during their prenatal care.