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HERPES ZOSTER TANISIYLA TAKİP EDİLEN HASTALARIN DEMOGRAFİK, KLİNİK VE LABORATUVAR ÖZELLİKLERİNİN DEĞERLENDİRİLMESİ

AMAÇ: Herpes zoster (HZ), varisella zoster virüsünün reaktivasyonusonucu meydana gelir. Öncelikle yaşlılarda ve bağışıklık sistemibaskılanmış kişilerde sık görülür. Zoster aşısının kullanılmayabaşlamasının ardından HZ sıklık ve komplikasyonlarında azalmaizlenmekle birlikte HZ, gelişmekte olan ülkeler için halen sorunteşkil etmektedir. Bu çalışmanın amacı HZ tanısıyla takip edilenhastaların demografik özellikleri, hastalıkla ilişkili klinik özelliklerive laboratuvar bulgularını değerlendirmektir.GEREÇ VE YÖNTEM: Mayıs 2014- Mayıs 2018 tarihleri arasındadermatoloji kliniğine HZ tanısıyla başvuran hastalar ICD 10 kodları(B02, B02.3, B02.8, B02.9) taranarak belirlendi. Üç bin sekiz yüzelli altı hastanın elektronik dosya kayıtları geriye dönüşlü olarakincelendi ve hastalık özellikleri kaydedildi.BULGULAR: Hastaların %47,6’sı kadın %52,4’ü erkekti. Ortalamayaş 50,89 (±18.3) olarak hesaplandı. HZ insidansında mevsimleregöre farklılık izlenmedi (ilkbahar: %27,1; yaz: %22,9; sonbahar:%25,6; kış: %24,4). Ancak, hospitalizasyon ve oküler komplikasyonsıklığında sırasıyla ilkbahar (ilkbahar: %36; yaz: %23; sonbahar:%25; kış: %16) ve sonbahar (ilkbahar: %23,1; yaz: %7,7; sonbahar:%53,8; kış: %15,4) aylarında artış görüldü. Oftalmik tutulumhospitalize edilen hastaların %13’ünde izlendi ve yapılan lojistikregresyon analizi yaş, mevsim ve kan platelet dağılım genişliği(PDW) düzeylerinin oküler komplikasyon riski ile ilişkili olduğunugösterdi. Sonbahar mevsiminde başvuran hastalar diğer mevsimlerile karşılaştırıldığında oftalmik tutulum için artmış riske sahiplerdi.Mevsime ek olarak PDW düzeylerindeki her bir birimlik azalma veyaştaki her bir yıllık artış oküler komplikasyon riskini 1,29 (%95GA: 1,01-1,69; p=0,048) ve 1,08 (%95 GA: 1,009-1,156; p=0,026)kat arttırmaktaydı.SONUÇ: HZ epidemiyolojisi ve oftalmik tutulum için riskfaktörlerinin belirlenmesi hasta yönetiminde klinisyene yardımcıolabilir.

EVALUATION OF DEMOGRAPHIC, CLINICAL AND LABORATORY CHARACTERISTICS OF PATIENTS FOLLOWED WITH HERPES ZOSTER

AIM: Herpes zoster (HZ) is caused by reactivation of varicella zoster virus and it is more prominent among elderly and patients with immune suppression. Although a decrease in both incidence and complication of HZ is observed after the zoster vaccine became available, HZ remains a problem in developing counties. The aim of this study is to evaluate demographic, clinical and laboratory characteristics of patients with HZ. MATERIAL AND METHOD: Patients administered to dermatology clinic with HZ between May 2014-May 2018 were identified by ICD 10 codes (B02, B02.3, B02.8, B02.9). Electronic chards of 3856 patients were reviewed and disease features were recorded. RESULTS: Forty-seven point six of the patients were male and 52.4% were female. The main age was calculated as 50.89 (±18.3). Incidence of HZ did not vary with season (spring: 27.1%, summer: 22.9%, autumn: 25.6%, winter: 24.4%) but hospitalization and ocular complication rates tended to increase in spring (spring: 36%, summer: 23%, autumn: 25%, winter: 16%) and autumn (spring: 23.1%, summer: 7.7%, autumn: 53.8%, winter: 15.4%) seasons respectively. Ocular involvement was observed in 13% of the hospitalized patients. Patients administered in autumn had a higher risk of ocular involvement compared to other seasons (OR: 4.87, 95% CI: 1.28-18.53, p=0.020). Every one-unit decrease in PDW and every one-year increase in age increased the risk of ocular complications by 1.29 (95% CI: 1.01-1.69, p=0.048) and 1.08 (95% CI: 1.009-1.156, p=0.026) fold respectively. CONCLUSION: Identification of risk factor for ocular involvement and HZ epidemiology may help the physician during patient management.

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