Patients with appendectomy are at increased risk of herpes zoster: real-world data in Taiwan

  • Shih-Wei LaiEmail author
  • Cheng-Li Lin
CE - Research Letter to the Editor

Some case reports showed that despite being rare, acute appendicitis could be caused by primary varicella-zoster virus infection [1]. Epidemiologic studies have shown that appendectomy is associated with increased risk of various infections including pyogenic liver abscess and biliary tract infection [2, 3], but the relationship between appendectomy and herpes zoster has not yet been explored. To explore this relationship, a cohort study was conducted using the database of the Taiwan National Health Insurance Program with 23 million citizens living in an independent country of Taiwan [4].

Subjects aged 20–84 years with newly diagnosed appendectomy from 2000 to 2012 were identified as the appendectomy group. To increase a statistic power, for each subject with appendectomy, four sex-matched and age-matched subjects without appendectomy were identified as the non-appendectomy group. Both appendectomy and non-appendectomy groups were followed until herpes zoster was newly diagnosed or...



This study was supported in part by the Ministry of Health and Welfare in Taiwan (MOHW107-TDU-B-212-123004) and China Medical University Hospital in Taiwan (DMR-107-192). These funding agencies did not influence the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author contributions

S-WL contributed to the conception of the article, initiated the draft of the article, and revised the article. C-LL conducted data analysis.

Compliance with ethical standards

Conflict of interest

The authors disclose no conflicts of interest.

Statement of human and animal rights

Insurance reimbursement claims data used in this study were available for public access. Patient identification numbers were scrambled to ensure confidentiality. This study was approved by the Research Ethics Committee of China Medical University and Hospital in Taiwan (CMUH-104-REC2-115).

Informed consent

Patient informed consent was not required.


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Copyright information

© Società Italiana di Medicina Interna (SIMI) 2018

Authors and Affiliations

  1. 1.College of MedicineChina Medical UniversityTaichungTaiwan
  2. 2.Department of Family MedicineChina Medical University HospitalTaichungTaiwan
  3. 3.Management Office for Health DataChina Medical University HospitalTaichungTaiwan

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