The risk for stroke increases significantly in the weeks after the 
onset of herpes zoster, especially cases of zoster affecting the 
distribution of the trigeminal nerve, according to a Clinical 
Infectious Diseases study.

Using a U.K. general practice database, researchers studied some 6500 
patients who had zoster and subsequent stroke. The observations began 
in the baseline period before the onset of zoster and extended for at 
least a year.

Patients were at greatest risk in the first 4 weeks after zoster 
onset, having an incidence ratio of 1.63 relative to baseline. The 
ratio in weeks 13 through 26 declined to 1.23, becoming nonsignificant 
thereafter. Stroke risks were especially strong after zoster 
ophthalmicus.

Roughly half the patients received oral antiviral treatment, and among 
those, there was a protective effect. The authors, suspecting a role 
for vasculopathy, encourage improvement in what they see as a 
relatively low rate of treatment with antivirals.

Clinical Infectious Diseases article