Partner Bereavement and Risk of Herpes Zoster: Results from Two Population-Based Case-Control Studies in Denmark and the United Kingdom.

Schmidt, S.A. ; Vestergaard, M. ; Pedersen, H.S. ; Schønheyder, H.C. ; Thomas, S.L. ; Smeeth, L. ; Mansfield, K.E. ; Sørensen, H.T. ; Forbes, H.J. ; Langan, S.M. ;
Partner Bereavement and Risk of Herpes Zoster: Results from Two Population-Based Case-Control Studies in Denmark and the United Kingdom.
Clin Infect Dis, 2016;

Psychological stress is commonly thought to increase the risk of herpes zoster by causing immunosuppression. However, epidemiological studies on the topic are sparse and inconsistent. We conducted two parallel case-control of the association between partner bereavement and risk of zoster using electronic healthcare data covering the entire Danish population and general practices in the UK Clinical Practice Research Datalink.

We included patients with a zoster diagnosis from primary care or hospital diagnosis of zoster in 1997-2013 in Denmark (n=190,671) and 2000-2013 in the UK (n=150,207). We matched up to four controls to each case by age, sex, and general practice (UK only) using risk-set sampling. The date of diagnosis was the index date for cases and their controls. We computed adjusted odds ratios with 99% confidence intervals for previous bereavement among cases vs. controls using conditional logistic regression with results from the two settings pooled using random-effects meta-analysis.

Overall, the adjusted odds ratios for the association between partner bereavement and zoster were 1.05 (1.03-1.07) in Denmark and 1.01 (0.98-1.05) in the UK. The pooled estimates were 0.72, 0.90, 1.10, 1.08, 1.02, 1.04, and 1.03 for bereavement within 0-7 days, 8-14 days, 15-30 days, 31-90 days, 91-365 days, 366-1095 days, and >1095 days before the index date, respectively.

We found no consistent evidence of an increased risk of zoster following partner death. Initial fluctuations in estimates may be explained by delayed healthcare contact due to the loss.