What is the risk of getting Herpes Zoster if I have rheumatoid arthritis?
Having rheumatoid arthritis (RA) increases your risk of developing herpes zoster, commonly known as shingles. Research indicates that people with RA face a roughly 30% higher risk of getting shingles compared to those without chronic conditions. This risk is driven by the immune system changes associated with both the autoimmune disease and the medications used to treat it.
What the research says
A large analysis of German health data found that patients with rheumatoid arthritis had the highest odds ratio for developing shingles among several chronic conditions studied, with risk estimates ranging from 1.37 to 1.57 across different age groups 8. This means the risk is consistently elevated regardless of age, though the absolute chance of getting shingles still depends on individual factors like age and gender 1.
Another comprehensive review of over 472,000 patients found that the overall proportion of people with RA who developed shingles was about 6%, but the prediction interval was wide, ranging from 5% to 45% 1. This wide range highlights that the risk varies significantly between individuals. The study identified that older age and female gender were also significant factors increasing the risk in this population 1.
The biological reason for this increased risk involves shared genetic signals that link aging, autoimmunity, and shingles 2. These genetic variations can alter the body's immune regulation, creating a state of high inflammatory burden that makes the virus more likely to reactivate 2. Additionally, the use of corticosteroids, a common treatment for RA, is strongly linked to shingles, with higher daily dosages significantly increasing the risk 1.
What to ask your doctor
- How does my current rheumatoid arthritis treatment plan affect my risk of getting shingles?
- At what age should I consider getting the shingles vaccine given my diagnosis of rheumatoid arthritis?
- Are there specific signs of shingles I should watch for given my immune system status?
- What steps can I take to reduce my risk of shingles reactivation while managing my RA?
This question is drawn from common patient questions about this topic and answered using cited medical research. We do not provide individualized advice.