Abstract

Herpes Zoster is a major public health problem and is an infection that results from re-activation of latent varicella infection acquired most commonly naturally or more recently through immunization. The incidence of HZ is approximately twice that of the general population in patients with immune mediated inflammatory diseases (IMIDs). Underlying mechanisms are largely those which compromise cell mediated immunity and epidemiologic risks largely follow immunosenescent patterns (i.e. aging). Rheumatologists use a large variety of immunosuppressive drugs which further increase the risk of HZ and are obliged to recognize the clinical syndrome, its complications, apply effective therapy and be actively engaged in strategies to maximize immunization and prevention. This discussion will focus on recent advances in each of these areas highlighting newly described complications of HZ such as stroke and advances in vaccine development.