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\begin{document}

\title{COPD and Herpes Zoster: Risk and Immunization}



\author[1]{Sneha Shrestha}%
\author[2]{Abhigan Shrestha}%
\author[1]{Abhyuday Yadav}%
\author[3]{Suyesh Shrestha}%
\author[1]{Selene Pokharel}%
\author[4]{sajina shrestha}%
\author[5]{Lok Shrestha}%
\affil[1]{Kathmandu University School of Medical Sciences}%
\affil[2]{Dinajpur Medical College}%
\affil[3]{Kathmandu University Hospital}%
\affil[4]{KIST Medical College}%
\affil[5]{University of New South Wales}%


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  \date{June 02, 2024}


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\begin{abstract}
Varicella Zoster is a neurotropic virus which leads to acute varicella
or it may lay dormant in the spinal root ganglion. Reactivation of
varicella zoster causes Herpes Zoster (HZ) and occurs commonly in
immunosuppressed conditions like COPD. Severity of Herpes Zoster is also
higher among those with comorbidities like COPD. Even among COPD
patients, the severity of HZ is said to be higher among those using oral
corticosteroids than those using inhaled steroids due to greater
immunosuppressive effect. It has also been found that incidence rate of
COPD exacerbations, transient ischemic attack and stroke are higher
among COPD patients with HZ compared to those without HZ. Herpes zoster
vaccinations prevent reactivation of latent HZ and reduce the associated
complications. Live attenuated and recombinant vaccines are available
for vaccination among which recombinant vaccine is found to be more
effective. The cost burden due to HZ among COPD patients was also higher
compared to those without HZ. Childhood varicella vaccination is cost
effective, however cost effectiveness of adolescent vaccination is
unclear.%
\end{abstract}%



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