Hospitalization for Varicella and Zoster in Children with Inflammatory Bowel Disease

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• 作者：Daniel J. Adams ; MD ; ^{daniel.adams@usuhs.edu" class="auth_mail" title="E-mail the corresponding author} ; Cade M. Nylund ; MD
• 关键词：CCS ; Clinical Classification Software ; HCUP-KID ; Healthcare Cost and Utilization Project Kids' Inpatient Database ; IBD ; Inflammatory bowel disease ; ICD-9-CM ; International Classification of Diseases ; Ninth Revision ; Clinical Modification ; LOS ; Length of stay ; TNF-α ; Tumor necrosis factor alpha ; VZV ; Varicella-zoster virus
• 刊名：The Journal of Pediatrics
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：171
• 期：Complete
• 页码：140-145
• 全文大小：322 K

文摘

To evaluate the association between inflammatory bowel disease (IBD) and varicella- and herpes zoster–related pediatric hospitalizations.

Study design

We performed a cross-sectional inpatient study using the triennial Healthcare Cost and Utilization Project Kids' Inpatient Database for years 1997-2012 to evaluate the association between a secondary diagnosis of IBD and a primary diagnosis of varicella or herpes zoster for hospitalized children ages 5-20 years. Billing codes were used to identify varicella, herpes zoster, ulcerative colitis, Crohn's disease, and other immunocompromising conditions. A logistic regression model was fitted to quantify the odds of varicella or zoster between these categories.

Results

There were 8 828 712 weighted admissions meeting the study criteria, 4434 with varicella and 4488 with herpes zoster. There was an association of IBD and immunocompromising conditions with hospitalization for varicella and herpes zoster. This association was stronger among children with Crohn's disease (varicella OR, 12.75; 95% CI, 8.30-19.59; zoster OR, 7.91; 95% CI, 5.60-11.18) compared with children with ulcerative colitis (varicella OR 4.25; 95% CI 1.98-9.12, zoster OR 3.90; 95% CI 1.98-7.67).

Conclusions

IBD in children is associated with hospitalizations for varicella and herpes zoster. These results highlight the importance of efforts to vaccinate patients with IBD without varicella immunity, ideally before the initiation of immunosuppressive therapy. Furthermore, research is needed on the safety and efficacy of the varicella vaccine in children with IBD on immunomodulators or biologic therapy.