{
  "abstract": "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.",
  "authors": [
    {
      "affiliations": [
        "Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina",
        "Hospital Escuela Eva Peron, Granadero Baigorria, Argentina"
      ],
      "name": "Romina Nieto"
    },
    {
      "affiliations": [
        "GLADEL Consultant, Rosario, Argentina"
      ],
      "name": "Lucia Hernández"
    },
    {
      "affiliations": [
        "Hospital Italiano de Buenos Aires, Rheumatlogy Unit, Buenos Aires, Argentina"
      ],
      "name": "Marina Scolnik"
    },
    {
      "affiliations": [
        "Hospital Italiano de Córdoba, Córdoba, Argentina"
      ],
      "name": "Laura Maurelli"
    },
    {
      "affiliations": [
        "Servicio de Reumatología, Hospital Córdoba, Córdoba, Argentina",
        "Sanatorio Allende, Córdoba, Argentina"
      ],
      "name": "Carla Gobbi"
    },
    {
      "affiliations": [
        "Reumatology, Hospital Privado Centro Médico de Córdoba, Córdoba, Argentina"
      ],
      "name": "Veronica Saurit"
    },
    {
      "affiliations": [
        "Hospital San Martin de La Plata, La Plata, Argentina"
      ],
      "name": "Lucila Garcia"
    },
    {
      "affiliations": [
        "Sanatorio Británico SA, Rosario, Argentina"
      ],
      "name": "Boris Kisluk"
    },
    {
      "affiliations": [
        "Hospital Padilla, Tucumán, Argentina"
      ],
      "name": "María Constanza Bertolaccini"
    },
    {
      "affiliations": [
        "Hospital J.M Ramos Mejía, Buenos Aires, Argentina"
      ],
      "name": "Melissa Serna Góngora"
    },
    {
      "affiliations": [
        "Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Buenos Aires, Argentina"
      ],
      "name": "Graciela N Gómez"
    },
    {
      "affiliations": [
        "Rheumatology and Immunology Section, CEMIC, Buenos Aires, Argentina"
      ],
      "name": "Cecilia Pisoni"
    },
    {
      "affiliations": [
        "Hospital Señor del Milagro Salta, Salta, Argentina"
      ],
      "name": "Ana Carolina Ralle"
    },
    {
      "affiliations": [
        "Hospital General de Agudos Dr. Juan A. Fernández, Buenos Aires, Argentina"
      ],
      "name": "Paola Pirruccio"
    },
    {
      "affiliations": [
        "Medical School of Federal University, Goias, Brazil"
      ],
      "name": "Vitalina de Souza Barbosa"
    },
    {
      "affiliations": [
        "Rheumatology Department, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil"
      ],
      "name": "Andrese Gasparin"
    },
    {
      "affiliations": [
        "Universidade Federal de Pernambuco, Recife, Brazil"
      ],
      "name": "Angela Duarte"
    },
    {
      "affiliations": [
        "Hospital Universitário Pedro Ernesto, Rio de Janeiro, Brazil",
        "Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil"
      ],
      "name": "Laíssa Cristina Alves Alvino"
    },
    {
      "affiliations": [
        "Rheumatology, Universidade de Sao Paulo Faculdade de Medicina Hospital das Clinicas, Sao Paulo, Brazil"
      ],
      "name": "Eduardo F Borba"
    },
    {
      "affiliations": [
        "Hospital das Clinicas HCFMUSP, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil"
      ],
      "name": "Eloisa Bonfá"
    },
    {
      "affiliations": [
        "Rheumatology Divison, Department of Medicine, Escola Paulista de Medicina / Universidade Federal de São Paulo, Sao Paulo, Brazil"
      ],
      "name": "Edgard Torres dos Reis-Neto"
    },
    {
      "affiliations": [
        "Hospital Del Salvador, Santiago, Chile"
      ],
      "name": "Alexis Bondi Peralta"
    },
    {
      "affiliations": [
        "Facultad de Medicina, Universidad San Sebastián, Santiago de Chile, Hospital Dr. Franco Ravera Zunino, Rancagua, Chile"
      ],
      "name": "Loreto Massardo"
    },
    {
      "affiliations": [
        "Clínica de la Costa, Barranquilla, Colombia",
        "Universidad Simón Bolívar Facultad de Ciencias de la Salud, Barranquilla, Colombia"
      ],
      "name": "Gustavo Aroca Martínez"
    },
    {
      "affiliations": [
        "Clínica de la Costa, Barranquilla, Colombia",
        "Universidad Simón Bolívar Facultad de Ciencias de la Salud, Barranquilla, Colombia"
      ],
      "name": "Antonio Iglesias Gamarra"
    },
    {
      "affiliations": [
        "Fundación Valle del Lili, Universidad Icesi, Cali, Colombia"
      ],
      "name": "Carlos A Cañas"
    },
    {
      "affiliations": [
        "Facultad de Medicina, Universidad Nacional de Colombia, Servicio de Reumatología, Hospital Universitario Fundación Santa Fe de Bogotá",
        "Hospital Universitario Nacional de Colombia, Bogotá, Colombia"
      ],
      "name": "Gerardo Quintana López"
    },
    {
      "affiliations": [
        "Centro de Referencia en Osteoporosis & Reumatología, Cali, Colombia",
        "Pontificia Universidad Javeriana, Cali, Colombia"
      ],
      "name": "Leon Frederick Silvery"
    },
    {
      "affiliations": [
        "Servicio de Reumatología, Instituto de Reumatología, Hematología y Dermatología (IRHED), Guayaquil, Ecuador"
      ],
      "name": "Jose Maximiliano Martinez"
    },
    {
      "affiliations": [
        "Hospital de Especialidades Dr. Antonio Fraga Mouret, Mexico City, Mexico",
        "Instituto Mexicano del Seguro Social, Mexico City, Mexico"
      ],
      "name": "Reyna Sánchez-Briones"
    },
    {
      "affiliations": [
        "Hospital de Especialidades del Centro Médico Nacional SXXI, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, Mexico"
      ],
      "name": "Mario Pérez Cristóbal"
    },
    {
      "affiliations": [
        "Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico"
      ],
      "name": "Eduardo Martín-Nares"
    },
    {
      "affiliations": [
        "Departamento de Reumatología, Instituto Nacional de Cardiología “Ignacio Chávez”, Ciudad de México, Mexico"
      ],
      "name": "Luis H Silveira"
    },
    {
      "affiliations": [
        "Centro de Estudios de Investigación Básica y Clínica, S.C, Guadalajara, Mexico"
      ],
      "name": "Ignacio García De La Torre"
    },
    {
      "affiliations": [
        "Hospital Central Dr Ignacio Morones Prieto, San Luis Potosi, Mexico"
      ],
      "name": "Julio César Ramírez Sánchez"
    },
    {
      "affiliations": [
        "Internal Medicine Department and Rheumatology Service, Hospital Universitario \"Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Mexico"
      ],
      "name": "Jorge Antonio Esquivel-Valerio"
    },
    {
      "affiliations": [
        "Universidad Nacional de Asunción Facultad de Ciencias Médicas, Asunción, Paraguay"
      ],
      "name": "Jhonatan Losanto"
    },
    {
      "affiliations": [
        "Universidad Nacional de Asunción Facultad de Ciencias Médicas, Asunción, Paraguay"
      ],
      "name": "Marcos Aurelio Vazquez"
    },
    {
      "affiliations": [
        "Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru"
      ],
      "name": "Magaly Alva Linares"
    },
    {
      "affiliations": [
        "Grupo Peruano de Estudio de Enfermedades Autoinmunes Sistemicas, Universidad Científica del Sur, Lima, Peru",
        "Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud, Lima, Peru"
      ],
      "name": "Manuel F Ugarte-Gil"
    },
    {
      "affiliations": [
        "Servicio de Inmunología y Reumatología, Hospital Nacional Cayetano Heredia, Universidad Peruana Cayetano Heredia, Lima, Peru"
      ],
      "name": "Armando Calvo-Quiroz"
    },
    {
      "affiliations": [
        "Hospital Docente Padre Billini, Santo Domingo, Dominican Republic"
      ],
      "name": "Teresandris Polanco"
    },
    {
      "affiliations": [
        "Unidad de Enfermedades Autoinmunes Sistémicas, Hospital de Clínicas, Montevideo, Uruguay"
      ],
      "name": "Carina Pizzarossa"
    },
    {
      "affiliations": [
        "Unidad de Enfermedades Autoinmunes, Médica Uruguaya, Corporación de Asistencia Médica, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay"
      ],
      "name": "Gonzalo Silveira"
    },
    {
      "affiliations": [
        "Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina"
      ],
      "name": "Bernardo A Pons-Estel"
    },
    {
      "affiliations": [
        "Department of Medicine, Division of Clinical Immunology and Rheumatology, School of Medicine, The University of Alabama, Birmingham, Alabama, USA"
      ],
      "name": "Graciela S Alarcon"
    },
    {
      "affiliations": [
        "Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina"
      ],
      "name": "Guillermo Pons-Estel"
    }
  ],
  "title": "Frequency and associated factors of herpes zoster infection in SLE patients from Latin America: data from the GLADEL 2.0 cohort",
  "uid": "ee3cb55e-3a32-5fbd-b571-e43fa0ba75dc"
}