What are the risk factors in children and adults for the development of herpes zoster (shingles)?

Updated: Feb 11, 2021
  • Author: Camila K Janniger, MD; Chief Editor: Dirk M Elston, MD  more...
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Known risk factors for developing herpes zoster relate to the status of cell-mediated immunity to VZV. Risk factors in children and adults include the following:

  • VZV-specific immunity and cell-mediated immunity, which generally declines with age

  • Immunosuppression (eg, by HIV infection or AIDS) [17, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31]

  • Immunosuppressive therapy [32, 33]

  • Primary VZV infection in utero or in early infancy, when the normal immune response is decreased

  • Anti-tumor necrosis factor (TNF)-a agents (may pose an increased risk) [34]

  • Immune reconstitution inflammatory syndrome (IRIS)

  • Acute lymphocytic leukemia and other malignancies

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