Table of Contents
The Aging Process. The risk for herpes zoster increases as people age. The risk for postherpetic neuralgia (PHN) is also highest in older people and increases dramatically after age 50. PHN is persistent nerve pain and is the most feared complication of shingles.
Immunosuppression. People whose immune systems are damaged from diseases such as AIDS or childhood cancer have a risk for herpes zoster that is much higher than those with healthy immune systems. Herpes zoster in people who are HIV-positive may be a sign of full-blown AIDS. Certain drugs used for treating HIV, such as protease inhibitors, may also increase the risk for herpes zoster.
Cancer. Cancer places people at risk for herpes zoster. At highest risk for developing shingles are those with Hodgkin's disease followed by patients with lymphomas. Chemotherapy itself increases the risk for herpes zoster.
Immunosuppressant Drugs. Patients who take certain drugs that suppress the immune system are at risk for shingles (as well as other infections). They include:
- Azathioprine (Imuran)
- Chlorambucil (Leukeran)
- Cyclophosphamide (Cytoxan)
- Cyclosporine (Sandimmune, Neoral)
- Cladribine (Leustatin)
- Infliximab (Remicade)
- Adalimumab (Humira)
- Prednisone and other corticosteroids
These drugs are used for patients who have undergone organ transplantation and are also used for treating autoimmune diseases. Such disorders include rheumatoid arthritis, systemic lupus erythematosus, diabetes, multiple sclerosis, Crohn's disease, and ulcerative colitis.
Risk Factors for Shingles in Children. Although most common in adults, shingles occasionally develops in children. Children with immune deficiencies are at highest risk. Children with no immune problems but who had chickenpox before they were 1 year old also have a higher risk for shingles.
Risk for Recurrence of Shingles. Shingles can recur, but the risk is low (about 6%). Evidence suggests that a first zoster episode may boost the immune system to ward off another attack. However, people who had long-lasting shingles pain after their first episode, or patients who are immunocompromised, may be at higher risk for recurrence.
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Review Date: 05/03/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine,
Harvard Medical School; Physician, Massachusetts General Hospital.
Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M.,
Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
