{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T14:18:45Z","timestamp":1781014725114,"version":"3.54.1"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,10,23]],"date-time":"2013-10-23T00:00:00Z","timestamp":1382486400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Data on the incidence, timing, and risk factors for herpes zoster (<jats:styled-content style=\"fixed-case\">HZ<\/jats:styled-content>) in heart transplant (<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>) recipients are limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We determined <jats:styled-content style=\"fixed-case\">HZ<\/jats:styled-content> incidence rates and actuarial estimates of time to first <jats:styled-content style=\"fixed-case\">HZ<\/jats:styled-content> episode in 314 <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content> recipients at our institution from 1995 to 2010. We developed <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ox models to assess potential risk factors for <jats:styled-content style=\"fixed-case\">HZ<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median age at <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content> was 54 (range, 17\u201371) years; 237 (76%) were male. There were 60 episodes of <jats:styled-content style=\"fixed-case\">HZ<\/jats:styled-content> in 51 patients, with an overall incidence rate of 31.6 cases (95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>], 23.5\u201341.6)\/1000 person\u2010years. Although most cases occurred during the first post\u2010<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content> year, cumulative <jats:styled-content style=\"fixed-case\">HZ<\/jats:styled-content> incidence was 0.078 at 1, 0.15 at 5, and 0.20 at 10\u00a0years. Many patients had substantial <jats:styled-content style=\"fixed-case\">HZ<\/jats:styled-content> morbidity, including 14% with HZ ophthalmicus and 45% with post\u2010herpetic neuralgia. Adjusting for age, gender, and acute cellular rejection episodes, exposure to mycophenolate mofetil (<jats:styled-content style=\"fixed-case\">MMF<\/jats:styled-content>) was an independent risk factor for <jats:styled-content style=\"fixed-case\">HZ<\/jats:styled-content> (adjusted hazard ratio [<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>] 2.18; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.20\u20133.96; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01), while ganciclovir\u2010based cytomegalovirus prophylaxis reduced <jats:styled-content style=\"fixed-case\">HZ<\/jats:styled-content> risk (adjusted <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 0.09; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.01\u20130.71; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02). Although age and female gender increased <jats:styled-content style=\"fixed-case\">HZ<\/jats:styled-content> risk, the magnitude of their effect was not statistically significant in <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ox models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">HZ<\/jats:styled-content> is common and morbid after <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>, particularly with <jats:styled-content style=\"fixed-case\">MMF<\/jats:styled-content> exposure. Ganciclovir prophylaxis is effective in reducing the short\u2010term risk of <jats:styled-content style=\"fixed-case\">HZ<\/jats:styled-content>, but the steady incidence of cases for years post <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content> makes long\u2010term <jats:styled-content style=\"fixed-case\">HZ<\/jats:styled-content> prevention challenging. Augmenting varicella zoster virus immunity post <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content> with vaccines warrants further exploration.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.12149","type":"journal-article","created":{"date-parts":[[2013,10,23]],"date-time":"2013-10-23T07:51:51Z","timestamp":1382514711000},"page":"17-25","source":"Crossref","is-referenced-by-count":48,"title":["Incidence and risk factors for herpes zoster following heart transplantation"],"prefix":"10.1111","volume":"16","author":[{"given":"S.","family":"Koo","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.S.","family":"Gagne","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston 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