{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T17:07:00Z","timestamp":1774285620105,"version":"3.50.1"},"reference-count":23,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"unspecified","delay-in-days":81,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004330","name":"GlaxoSmithKline","doi-asserted-by":"publisher","award":["Funding for this study was provided by GSK."],"award-info":[{"award-number":["Funding for this study was provided by GSK."]}],"id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2026,2,18]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study was to assess the epidemiological and clinical characteristics of herpes zoster (HZ) and to identify the factors associated with its first episode in Latin American SLE patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>GLADEL 2.0 (Grupo Latino Americano De Estudio del Lupus) is a multiethnic, Latin American observational cohort of SLE patients. Demographic, clinical, laboratory, treatment and disease activity\/damage data were compared between patients with and without HZ; its prevalence was assessed at cohort entry, incidence rates of first and recurrent HZ infections were calculated based on person-years of follow-up. Logistic regression was used to identify factors associated with HZ events, while Cox regression was used to determine the variables associated with time to first event.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1083 SLE patients, the HZ cumulative incidence after its diagnosis was 11.5%, with a prevalence of 8.6% at cohort entry. During 5-year of follow-up, the incidence of HZ was 2.9% and 16.8% patients had recurrent episodes. Patients with HZ showed higher frequencies of alopecia, psychosis and seizures, along with higher disease activity, damage accrual, proteinuria and higher daily prednisone doses prior to the event. Multivariate analyses identified female sex, higher SLE Disease Activity Index 2000 (SLEDAI-2K) and higher daily prednisone dose as independent predictors of HZ occurrence. Older age at diagnosis, psychosis, disease activity and a higher daily prednisone dose were associated with a shorter time to HZ onset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In the GLADEL 2.0 cohort, the high burden of HZ in SLE, together with its association with active disease, corticosteroid exposure and neuropsychiatric manifestations, underscores the need for proactive risk stratification in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/lupus-2025-001877","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T16:25:22Z","timestamp":1774283122000},"page":"e001877","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Frequency and associated factors of herpes zoster infection in SLE patients from Latin America: data from the GLADEL 2.0 cohort"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2895-3060","authenticated-orcid":false,"given":"Romina","family":"Nieto","sequence":"first","affiliation":[{"name":"Centro Regional de Enfermedades Autoinmunes y Reum\u00e1ticas (GO-CREAR), Rosario, Argentina"},{"name":"Hospital Escuela Eva Peron, Granadero Baigorria, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"GLADEL Consultant, Rosario, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Scolnik","sequence":"additional","affiliation":[{"name":"Hospital Italiano de Buenos Aires, Rheumatlogy Unit, Buenos Aires, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Maurelli","sequence":"additional","affiliation":[{"name":"Hospital Italiano de C\u00f3rdoba, C\u00f3rdoba, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carla","family":"Gobbi","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda, Hospital C\u00f3rdoba, C\u00f3rdoba, Argentina"},{"name":"Sanatorio Allende, C\u00f3rdoba, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronica","family":"Saurit","sequence":"additional","affiliation":[{"name":"Reumatology, Hospital Privado Centro M\u00e9dico de C\u00f3rdoba, C\u00f3rdoba, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucila","family":"Garcia","sequence":"additional","affiliation":[{"name":"Hospital San Martin de La Plata, La Plata, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boris","family":"Kisluk","sequence":"additional","affiliation":[{"name":"Sanatorio Brit\u00e1nico SA, Rosario, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Constanza","family":"Bertolaccini","sequence":"additional","affiliation":[{"name":"Hospital Padilla, Tucum\u00e1n, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Serna G\u00f3ngora","sequence":"additional","affiliation":[{"name":"Hospital J.M Ramos Mej\u00eda, Buenos Aires, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graciela N","family":"G\u00f3mez","sequence":"additional","affiliation":[{"name":"Instituto de Investigaciones M\u00e9dicas Alfredo Lanari, Universidad de Buenos Aires, Buenos Aires, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilia","family":"Pisoni","sequence":"additional","affiliation":[{"name":"Rheumatology and Immunology Section, CEMIC, Buenos Aires, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Carolina","family":"Ralle","sequence":"additional","affiliation":[{"name":"Hospital Se\u00f1or del Milagro Salta, Salta, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Pirruccio","sequence":"additional","affiliation":[{"name":"Hospital General de Agudos Dr. Juan A. Fern\u00e1ndez, Buenos Aires, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vitalina","family":"de Souza Barbosa","sequence":"additional","affiliation":[{"name":"Medical School of Federal University, Goias, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrese","family":"Gasparin","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Duarte","sequence":"additional","affiliation":[{"name":"Universidade Federal de Pernambuco, Recife, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"La\u00edssa Cristina","family":"Alves Alvino","sequence":"additional","affiliation":[{"name":"Hospital Universit\u00e1rio Pedro Ernesto, Rio de Janeiro, Brazil"},{"name":"Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 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