Increased Incidence of Giant Cell Arteritis After Introduction of a Live Varicella Zoster Virus Vaccine
William A. Agger, Jake A. Deviley, Andrew J. Borgert, Cary Rasmussen
Abstract
Abstract Background Varicella zoster virus (VZV) has been associated with giant cell arteritis (GCA). The introduction of a live attenuated vaccine against this virus (ZVL) might have changed the incidence of GCA. Methods The incidence of GCA was retrospectively measured using 2 matched cohorts seen in a regional health system located in the Midwestern United States: ZVL recipients from the years 2007 through 2015 following the introduction of the vaccine and nonrecipients from the years 2000 through 2015. Results In the ZVL cohort, a significant increase of GCA was associated with clinical criteria alone for the diagnosis of GCA (hazard ratio [HR], 2.70; 95% CI, 1.48–4.45; P = .004). In addition, using only pathologically confirmed GCA, the same matched cohort comparison analysis also found that ZVL recipients were at significantly higher risk than those who did not receive ZVL (HR, 2.70; 95% CI, 1.48–4.95; P = .001). Conclusion Using a matched cohort, retrospective comparison, ZVL was associated with an increased incidence of GCA.