A population based study of the epidemiology of Herpes Zoster and its complications

J Infect. 2013 Nov;67(5):463-9. doi: 10.1016/j.jinf.2013.06.016. Epub 2013 Jul 16.

Abstract

Objectives: To assess the incidence of Herpes Zoster (HZ) and its complications in the Israeli general population and specifically in immune-compromised individuals, and to identify risk factors for developing HZ and post-herpetic neuralgia (PHN).

Methods: A retrospective database search for newly diagnosed cases of HZ and of PHN during 2006-2010 was conducted using the comprehensive longitudinal database of Maccabi Health Services. Cox-proportional hazards models were used to assess associations between risk factors and HZ and PHN.

Results: During 2006-2010 there were 28,977 newly diagnosed cases of HZ and 1508 newly diagnosed cases of PHN. Incidence density rate of HZ was 3.46 per 1000 person-years in the total population and 12.8 per 1000 person-years in immune-compromised patients. HZ and PHN incidence increased sharply with age. 12.4% and 3.1% of elderly HZ patients (≥ 65 years) developed PHN or ophthalmic complications, respectively. In multivariable analyses, HZ and PHN were associated with female sex, higher socioeconomic status, diabetes mellitus, cancer history, and HIV treatment.

Conclusions: Extrapolating to the entire Israeli population, we estimate over 24,000 new cases of HZ and 1250 new cases of PHN each year. Cost-effectiveness analysis should be performed to determine the threshold age for vaccination against HZ.

Keywords: Herpes Zoster; Incidence; Neuralgia; Postherpetic; Risk factors.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Female
  • Herpes Zoster / complications*
  • Herpes Zoster / epidemiology*
  • Humans
  • Incidence
  • Infant
  • Israel / epidemiology
  • Male
  • Middle Aged
  • Neuralgia, Postherpetic / epidemiology*
  • Neuralgia, Postherpetic / virology*
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors