A recent study of over 1.5 million people in the U.S. and the U.K. demonstrates that having rheumatoid arthritis (RA) increases the likelihood of developing herpes zoster, better known as shingles.
The U.S. research included health records from 122,000 RA patients and one million randomly selected controls. These records showed that the rate of shingles was significantly higher in the RA patients at a rate of 9.83 per 1,000 person-years compared to the controls at a rate of 3.71 per 1,000 person-years. That represents a 91% higher risk of shingles for patients with RA.
The U.K. research looked at health records for 38,000 RA patients and 500,000 randomly selected controls. This data showed RA patients with a rate of 10.6 per 1,000 person-years as opposed to the controls with a rate of 4.1 per 1,000 person-years. This represents a 65% higher risk of shingles for patients with RA.
The study, published in the medical journal, Arthritis Care and Research, indicated that it was not clear whether anti-RA medications increased the likelihood of developing shingles. It may have been that those with the higher risk of shingles also had more severe RA symptoms and therefore were more likely to be receiving more aggressive anti-RA treatment.
Shingles is a painful skin condition caused by a reactivation of the varicella zoster virus (VZV), the same virus that causes chicken pox. After a chickenpox infection has cleared the VZV can remain dormant in the nerve tract without causing any symptoms. The virus can be reactivated years, and even decades, later as a result of a compromised immune system. The first symptoms of shingles include headache, fever and malaise. These are typically followed by burning pain, itching and hypersensitivity. After a couple of days a rash develops which become blisters which crust over in 7 to 10 days. The crusts will fall off and the skin heals, although there may be scarring or discolored skin.