M HAMAD1, H ALLAM1, A SULAIMAN2, H HASSAN3,4
1Department of Medical Laboratory Sciences, College of Health Sciences, University of Sharjah, United Arab Emirates, 2Research Institute of Medical & Health Sciences, University of Sharjah, United Arab Emirates, 3Renal unit, Wollongong Hospital, Wollongong, Australia, 4Graduate School of Medicine, University of Wollongong, Wollongong, Australia
Aim: To conduct a meta-analysis and systematic review of herpes zoster vaccine (HZV) in preventing shingles and risk of adverse events in patients with chronic kidney disease (CKD).
Background: CKD affect 10% of the global population with patients at an increased risk of shingles. HZV is effective in preventing shingles in the elderly, however only a few studies examined vaccine effectiveness in patients with CKD.
Methods: MEDLINE, EMBASE and CENTRAL databases were searched for cohort or randomised controlled trails examining HZV effectiveness in the CKD population (CKD, dialysis or renal transplant), from inception through to May 31,2020. Outcomes were shingles or adverse event. Control group was placebo or no vaccine. Data were screened and extracted independently by 3 authors. Random effects meta-analysis were used to report the pooled treatment effects and 95% confidence intervals.
Results: We identified 2,618 studies of which 6 were eligible for inclusion. Total of 233,735 patients were included of which 15,032 received HZV and 218,703 were controls. Five studies examined HZV effectiveness and two risk of adverse events. Four studies were cohort analysis and two randomised controlled trails. Three studies examined CKD populations, one was in the dialysis population and two were in pre-transplant dialysis populations.
Overall risk of HZ was found to be lower in patients receiving HZV compared to those who did not (HR= 0.47; 95% CI: 0.40 to 0.55, p<0.01). There was no significant difference in adverse events associated with HZV (HR: 1.12, 95%CI: 0.87 to 1.44, p=0.93).
Conclusions: In this meta-analysis HZV in CKD patients ,compared to placebo or no vaccine, was significantly associated with a lower risk of shingles without an increased risk of adverse events.
Hicham Cheikh Hassan is a Consultant Nephrologist in the Illawarra Shoalhaven Local Health District. His research interest includes Clinical Epidemiology and infection as a risk factor in renal disease.