Objective: This study aimed to determine the frequency of shingles infections in Parkinson’s disease patients before or after diagnosis and to examine its possible relationship with disease severity.

Background: Shingles (Herpes Zoster) is an infection that is caused by reactivation of varicella zoster with an incidence of 7.2 per 1000.[1] In Turkey, zoster vaccine recombinant (ZVR) is recommended for ages 50 and above.[2] It has been stated that there may be a relationship between Parkinson’s disease (PD) and systemic infections, its relationship with Herpes Zoster is not clear.[3,4]

Method: Our hospital’s Parkinson’s Disease Cohort records were used in the study. Demographic and clinical characteristics and treatments were recorded. If the patients had shingles, the time and medications taken for shingles were noted. Possible associations with comorbid diseases were examined in those with a history of shingles.

Results: A total of 707 PD (female/male: 290/417) were included in the study. The mean age of the patients and age at diagnosis were 68.8 (10.5) and 63.2 (11.3) years. 49 (7.0%) patients were receiving device-aided treatment. Shingles was detected in a total of 19 (2.7%) patients. 14 patients had shingles before PD diagnosis and 5 patients had it during the PD period. Twelve patients used antiviral therapy. It was determined that 63.8% of the patients had hypertension (HT) and 32.9% had diabetes (DM). Autoimmune/autoinflammatory disease that may require immunosuppression was present in 7.9% of patients. In patients with a history of shingles, there was no increased frequency of device-assisted therapy use, concomitant autoimmune disease, diabetes, or chronic renal failure (p>0.05).

Conclusion: The prevalence of shingles infection in the Bilkent City Hospital Parkinson’s Disease Cohort is 2.7%. No association was found between concomitant autoimmune disease, DM, HT, and chronic renal failure and shingles infection. Prospective studies may provide more guidance in clearly establishing the relationship between PD and shingles. The recommendation for the shingles vaccine in PD can be considered within the same scope as the general population.

References: 1-Harpaz R, Leung JW. The Epidemiology of Herpes Zoster in the United States During the Era of Varicella and Herpes Zoster Vaccines: Changing Patterns Among Older Adults. Clin Infect Dis. 2019 Jul 2;69(2):341-344. doi: 10.1093/cid/ciy953. PMID: 30496358.

2-Dooling KL, Guo A, Patel M, et al. Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines. MMWR Morb Mortal Wkly Rep 2018;67:103–108.

3-Zhang Y, Liu W and Xu Y (2024) Association between herpes zoster and Parkinson’s disease and dementia: a systematic review and meta-analysis. Front. Neurol. 15:1471736.

4-Smeyne RJ, Noyce AJ, Byrne M, Savica R, Marras C. Infection and Risk of Parkinson’s Disease. J Parkinsons Dis. 2021;11(1):31-43. doi: 10.3233/JPD-202279. PMID: 33361610; PMCID: PMC7990414.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/frequency-of-shingles-infection-in-parkinson-patients-data-from-bilkent-city-hospital-cohort/