{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:25:07Z","timestamp":1740126307780,"version":"3.37.3"},"reference-count":39,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,11,5]],"date-time":"2017-11-05T00:00:00Z","timestamp":1509840000000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Immunosuppressed inflammatory bowel disease (<jats:styled-content style=\"fixed-case\">IBD<\/jats:styled-content>) patients have an increased risk of herpes zoster virus (<jats:styled-content style=\"fixed-case\">HZV<\/jats:styled-content>) infection. The existing live\u2010attenuated <jats:styled-content style=\"fixed-case\">HZV<\/jats:styled-content> vaccine is contraindicated in some of these patients and can only be used with caution in others.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To describe characteristics of <jats:styled-content style=\"fixed-case\">IBD<\/jats:styled-content> patients suffering <jats:styled-content style=\"fixed-case\">HZV<\/jats:styled-content> to enable implementation of risk mitigation strategies for those at highest risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Gastroenterologists completed a proforma for <jats:styled-content style=\"fixed-case\">IBD<\/jats:styled-content> patients who experienced <jats:styled-content style=\"fixed-case\">HZV<\/jats:styled-content> infection: <jats:styled-content style=\"fixed-case\">IBD<\/jats:styled-content> phenotype, details of <jats:styled-content style=\"fixed-case\">HZV<\/jats:styled-content> infection, immunosuppression and any change to treatment upon diagnosis of <jats:styled-content style=\"fixed-case\">HZV<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 30 cases was identified: Crohn disease (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>) (<jats:italic>n<\/jats:italic>\u2009=\u200925) and ulcerative colitis (<jats:italic>n<\/jats:italic>\u2009=\u20095). In total, 80% (20\/25) of the <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> patients had penetrating, stricturing or perianal disease. Time from commencement of immunosuppression to <jats:styled-content style=\"fixed-case\">HZV<\/jats:styled-content> infection was highly variable (range: 3\u2009months to over 10\u2009years). A total of 90% (27\/30) of patients was on at least one immunosuppressive therapy; of those, one\u2010third was on monotherapy (9\/27) and two\u2010thirds (18\/27) on dual therapy. A total of 89% (24\/27) of immunosupressed patients was on a thiopurine (monotherapy; 6\/27) or in combination (18\/27). Complications of <jats:styled-content style=\"fixed-case\">HZV<\/jats:styled-content> occurred in 27% (8\/30) of patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our series is consistent with existing epidemiological analysis that identified more severe <jats:styled-content style=\"fixed-case\">IBD<\/jats:styled-content> and the use of multiple immunosuppressive therapies as risk factors for <jats:styled-content style=\"fixed-case\">HZV<\/jats:styled-content>. If the promise of an investigational subunit <jats:styled-content style=\"fixed-case\">HZV<\/jats:styled-content> vaccine is realised in immunocompromised patients, better protection may be possible in the future. Thiopurine medications were the most commonly used immunosuppressant in this series. Age and duration of immunosuppressive therapy do not appear to predict <jats:styled-content style=\"fixed-case\">HZV<\/jats:styled-content> infection.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.13488","type":"journal-article","created":{"date-parts":[[2017,5,18]],"date-time":"2017-05-18T04:16:45Z","timestamp":1495081005000},"page":"1263-1269","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The need for better preventative strategies for inflammatory bowel disease patients at risk of herpes zoster virus"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4569-1648","authenticated-orcid":false,"given":"William A.","family":"Bye","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology St Vincent's Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miles P.","family":"Sparrow","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The Alfred Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan J.","family":"Connor","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The Liverpool Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane M.","family":"Andrews","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie","family":"Ellard","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Mater Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Watson","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The Liverpool Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgia","family":"Hume","sequence":"additional","affiliation":[{"name":"Gastroenterology Department Mater Private Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sally","family":"Antoniades","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology St Vincent's Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alissa J.","family":"Walsh","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology St Vincent's Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,11,5]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mib.0000231572.88806.b9"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2003.10.047"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2008.163642"},{"volume-title":"Vaccines","year":"2008","author":"Levin MK","key":"e_1_2_6_5_1"},{"key":"e_1_2_6_6_1","unstructured":"Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP). 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