{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T23:58:44Z","timestamp":1791244724268,"version":"4.1.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000124","name":"Office of Research on Women's Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000124","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 EY028739"],"award-info":[{"award-number":["R01 EY028739"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000053","name":"National Eye Institute","doi-asserted-by":"publisher","award":["EY06190"],"award-info":[{"award-number":["EY06190"]}],"id":[{"id":"10.13039\/100000053","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Department of Ophthalmology"},{"DOI":"10.13039\/100005595","name":"University of California","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001818","name":"Research to Prevent Blindness","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001818","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Herpes zoster (HZ) is associated with a higher risk of cardiovascular events, but the effect of the recombinant zoster vaccine (RZV) on this risk, alone or in combination with antiviral treatment, remains uncertain. The aim of this study was to evaluate the impact of RZV on the risk of cardiovascular disease (CVD) events following HZ infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using the Optum Labs Data Warehouse. Adults aged \u226550 years with HZ diagnosed between 1 January 2018 and 31 March 2023 were included. Participants were categorized by their receipt of RZV and antiviral treatment for HZ. A Cox multivariable proportional hazards model estimated the association with post-HZ cardiovascular events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 112 637 patients with HZ, 5240 (4.7%) received both RZV and antiviral therapy, 2644 (2.3%) received RZV alone, 80 871 (71.8%) received antiviral therapy alone, and 23 882 (21.2%) received neither. RZV alone reduced the CVD risk by 21% (95% confidence interval, 6%\u201333%), antiviral therapy alone by 22% (16%\u201326%), and receipt of both by 39% (28%\u201347%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study underscores the effectiveness of RZV and antiviral therapy in mitigating cardiovascular risks after HZ infection. Having both preventive vaccination and therapeutic antiviral intervention may offer enhanced protection against CVD and death.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiaf105","type":"journal-article","created":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T08:07:26Z","timestamp":1740643646000},"page":"465-473","source":"Crossref","is-referenced-by-count":14,"title":["Protective Effects of Recombinant Zoster Vaccine and Antiviral Therapy Against Cardiovascular Disease Following Herpes Zoster Infection"],"prefix":"10.1093","volume":"232","author":[{"given":"Xinyi","family":"Xu","sequence":"first","affiliation":[{"name":"F.I. Proctor Foundation, University of California , San Francisco, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Ray","sequence":"additional","affiliation":[{"name":"F.I. Proctor Foundation, University of California , San Francisco, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4097-0186","authenticated-orcid":false,"given":"Emily","family":"Tang","sequence":"additional","affiliation":[{"name":"F.I. Proctor Foundation, University of California , San Francisco, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6105-7295","authenticated-orcid":false,"given":"Benjamin F","family":"Arnold","sequence":"additional","affiliation":[{"name":"F.I. Proctor Foundation, University of California , San Francisco, California ,","place":["USA"]},{"name":"Department of Ophthalmology, University of California , San Francisco, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisha R","family":"Acharya","sequence":"additional","affiliation":[{"name":"F.I. Proctor Foundation, University of California , San Francisco, California ,","place":["USA"]},{"name":"Department of Ophthalmology, University of California , San Francisco, California ,","place":["USA"]},{"name":"Department of Epidemiology and Biostatistics, University of California , San Francisco, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,3,1]]},"reference":[{"key":"2025120912113497200_jiaf105-B1","author":"Centers for Disease Control and Prevention"},{"key":"2025120912113497200_jiaf105-B2","doi-asserted-by":"crossref","first-page":"e1335","DOI":"10.1093\/cid\/ciac549","article-title":"Increased stroke risk following herpes zoster infection and protection with zoster vaccine","volume":"76","author":"Parameswaran","year":"2023","journal-title":"Clin Infect Dis"},{"key":"2025120912113497200_jiaf105-B3","doi-asserted-by":"crossref","first-page":"e708","DOI":"10.1212\/WNL.0000000000010028","article-title":"Effect of herpes zoster vaccine and antiviral treatment on risk of ischemic stroke","volume":"95","author":"Yang","year":"2020","journal-title":"Neurology"},{"key":"2025120912113497200_jiaf105-B4","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.jacc.2017.05.015","article-title":"Herpes zoster increases the risk of stroke and myocardial infarction","volume":"70","author":"Kim","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"2025120912113497200_jiaf105-B5","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.1016\/j.jstrokecerebrovasdis.2017.04.013","article-title":"Risk of stroke\/transient ischemic attach or myocardial infarction with herpes zoster: a systematic review and meta-analysis","volume":"26","author":"Zhang","year":"2017","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"2025120912113497200_jiaf105-B6","doi-asserted-by":"crossref","first-page":"e1001919","DOI":"10.1371\/journal.pmed.1001919","article-title":"Acute cardiovascular events after herpes zoster: a self-controlled case series analysis in vaccinated and unvaccinated older residents of the United States","volume":"12","author":"Minassian","year":"2015","journal-title":"PLoS Med"},{"key":"2025120912113497200_jiaf105-B7","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1097\/MS9.0000000000000220","article-title":"Novel discovery of exosomes biomarker from herpes zoster viral infection: linking to cerebrovascular coincidence","volume":"85","author":"Amin","year":"2023","journal-title":"Ann Med Surg (Lond)"},{"key":"2025120912113497200_jiaf105-B8","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1093\/infdis\/jiac405","article-title":"Zoster-associated prothrombic plasma exosomes and increased stroke risk","volume":"227","author":"Bubak","year":"2023","journal-title":"J Infect Dis"},{"key":"2025120912113497200_jiaf105-B9","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1016\/S1474-4422(09)70134-6","article-title":"Varicella zoster virus vasculopathies: diverse clinical manifestations, laboratory features, pathogenesis, and treatment","volume":"8","author":"Gilden","year":"2009","journal-title":"Lancet Neurol"},{"key":"2025120912113497200_jiaf105-B10","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1186\/s12879-017-2278-z","article-title":"A meta-analysis of stroke risk following herpes zoster infection","volume":"17","author":"Marra","year":"2017","journal-title":"BMC Infect Dis"},{"issue":"suppl 4","key":"2025120912113497200_jiaf105-B11","doi-asserted-by":"crossref","first-page":"S429","DOI":"10.1093\/infdis\/jiab387","article-title":"Herpes zoster vaccines","volume":"224","author":"Harbeke","year":"2021","journal-title":"J Infect Dis"},{"key":"2025120912113497200_jiaf105-B12","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1093\/cid\/ciab121","article-title":"Effectiveness of the recombinant zoster vaccine in adults aged 50 and older in the United States: a claims-based cohort study","volume":"73","author":"Sun","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2025120912113497200_jiaf105-B13","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1161\/STROKEAHA.120.032788","article-title":"Herpes zoster vaccine live and risk of stroke among Medicare beneficiaries: a population-based cohort study","volume":"52","author":"Yang","year":"2021","journal-title":"Stroke"},{"key":"2025120912113497200_jiaf105-B14","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.36849\/JDD.7415","article-title":"Recombinant zoster vaccine reduces 3-year cardiovascular risk: insights from a multi-centered database","volume":"22","author":"Helm","year":"2023","journal-title":"J Drugs Dermatol"},{"key":"2025120912113497200_jiaf105-B15","doi-asserted-by":"crossref","first-page":"157","DOI":"10.3390\/jcm8040547","article-title":"Does herpes zoster increase the risk of stroke and myocardial infarction? A comprehensive review","volume":"8","author":"Wu","year":"2019","journal-title":"J of Clin Med"},{"key":"2025120912113497200_jiaf105-B16","volume-title":"Optum Labs and Optum Labs Data Warehouse (OLDW) descriptions and citation","author":"Optum Labs","year":"2023"},{"key":"2025120912113497200_jiaf105-B17","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.ajo.2022.06.020","article-title":"Prompt antiviral therapy is associated with lower risk of cerebrovascular accident following herpes zoster ophthalmicus","volume":"242","author":"Meyer","year":"2022","journal-title":"Am J Ophthalmol"},{"key":"2025120912113497200_jiaf105-B18","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1093\/gerona\/gly150","article-title":"Quality of life impact on an adjuvated recombinant zoster vaccine in adults aged 50 years and older","volume":"74","author":"Curran","year":"2019","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"2025120912113497200_jiaf105-B19","doi-asserted-by":"crossref","first-page":"2271","DOI":"10.1056\/NEJMoa051016","article-title":"A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults","volume":"352","author":"Oxman","year":"2005","journal-title":"N Engl J Med"},{"key":"2025120912113497200_jiaf105-B20","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1093\/aje\/kwx245","article-title":"Long-term effectiveness of the live zoster vaccine in preventing shingles: a cohort study","volume":"187","author":"Baxter","year":"2018","journal-title":"Am J Epidemiol"}],"container-title":["The Journal of Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jid\/advance-article-pdf\/doi\/10.1093\/infdis\/jiaf105\/62206633\/jiaf105.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jid\/article-pdf\/232\/2\/465\/62206633\/jiaf105.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jid\/article-pdf\/232\/2\/465\/62206633\/jiaf105.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T17:11:46Z","timestamp":1765300306000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jid\/article\/232\/2\/465\/8046239"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,1]]},"references-count":20,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,3,1]]},"published-print":{"date-parts":[[2025,8,14]]}},"URL":"https:\/\/doi.org\/10.1093\/infdis\/jiaf105","relation":{},"ISSN":["0022-1899","1537-6613"],"issn-type":[{"value":"0022-1899","type":"print"},{"value":"1537-6613","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,8,15]]},"published":{"date-parts":[[2025,3,1]]}}}