Frequency and associated factors of herpes zoster infection in SLE patients from Latin America: data from the GLADEL 2.0 cohort
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Fecha
2026
Autores
Nieto, Romina
Hernández, Lucia
Scolnik, Marina
Maurelli, Laura
Gobbi, Carla
Saurit, Veronica
Garcia, Lucila
Kisluk, Boris
Bertolaccini, Maria Constanza
Serna Gongora, Melissa Brenda
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BMJ Group
Resumen
Objective The aim of this study was to assess the
epidemiological and clinical characteristics of herpes zoster
(HZ) and to identify the factors associated with its first episode
in Latin American SLE patients.
Methods GLADEL 2.0 (Grupo Latino Americano De Estudio del
Lupus) is a multiethnic, Latin American observational cohort
of SLE patients. Demographic, clinical, laboratory, treatment
and disease activity/damage data were compared between
patients with and without HZ; its prevalence was assessed at
cohort entry, incidence rates of first and recurrent HZ infections
were calculated based on person-years
of follow-up.
Logistic
regression was used to identify factors associated with HZ
events, while Cox regression was used to determine the
variables associated with time to first event.
Results Among 1083 SLE patients, the HZ cumulative
incidence after its diagnosis was 11.5%, with a prevalence of
8.6% at cohort entry. During 5-year
of follow-up,
the incidence
of HZ was 2.9% and 16.8% patients had recurrent episodes.
Patients with HZ showed higher frequencies of alopecia,
psychosis and seizures, along with higher disease activity,
damage accrual, proteinuria and higher daily prednisone doses
prior to the event. Multivariate analyses identified female
sex, higher SLE Disease Activity Index 2000 (SLEDAI-2K)
and
higher daily prednisone dose as independent predictors of HZ
occurrence. Older age at diagnosis, psychosis, disease activity
and a higher daily prednisone dose were associated with a
shorter time to HZ onset.
Conclusion In the GLADEL 2.0 cohort, the high burden of
HZ in SLE, together with its association with active disease, corticosteroid exposure and neuropsychiatric manifestations,
underscores the need for proactive risk stratification in clinical
practice.
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Nieto R, Hernández L, Scolnik M, et al. Frequency and associated factors of herpes zoster infection in SLE patients from Latin America: data from the GLADEL 2.0 cohort. Lupus Science & Medicine 2026;13:e001877. doi:10.1136/lupus-2025-001877
