predisposition

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The following are factors which predispose the individual to develop shingles:

  • increasing age
    • disease is usually seen between the ages of 50 and 79 years.
      • VZV-specific cell-mediated immunity decreases with age which results in the increase  in incidence
    • VZV seropositivity can be observed in over 95% of immunocompetent individuals aged at least 50 years. Hence these patients are at risk of developing HZ
    • the lifetime risk of developing HZV rises from 25-30% to 50% in people aged at least 80 years
  • immunosuppression:
    • iatrogenic - one third of patients with Hodgkin's disease develop shingles within 2 years of aggressive chemotherapy; patients taking high-dose corticosteroid treatment are at risk of developing shingles
    • HIV
    • neoplastic disease
    • organ transplantation
  • additionally, the following factors have also been implicated to increase the risk of HZV
    • women are at increased risk than men
    • for whites than for blacks
    • persons with a family history of herpes zoster than for those without such a background
    • chickenpox that occurs in utero or early in infancy is associated with herpes zoster in the childhood
  • contact with chickenpox - in some susceptible individuals there is a risk of developing shingles following contact with a patient with chickenpox (mechanism is unclear)
  • shingles cannot be caught directly from a patient with shingles (1,2,3)

Reference:

Last edited 11/2018 and last reviewed 10/2021

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