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. 2014 Apr;42(2):325-34.
doi: 10.1007/s15010-013-0550-8. Epub 2013 Nov 10.

Incidence of herpes zoster in patients with altered immune function

S-Y Chen  1 , J A Suaya, Q Li, C M Galindo, D Misurski, S Burstin, M J Levin
Affiliations

Incidence of herpes zoster in patients with altered immune function

S-Y Chen et al. Infection. 2014 Apr.

Abstract

Purpose: To estimate the incidence of herpes zoster (HZ) and rates of post-zoster pain in both the total study population and separately in patients with selected conditions/treatments associated with altered immune function.

Methods: The health administrative claims databases for commercially insured, Medicare, and Medicaid populations, together accounting for approximately 51 million insured individuals, were analyzed between 2005 and 2009 in a retrospective cohort study. Incidence of HZ episodes per 1,000 person-years (PY) was estimated in all study populations as well as within nine potentially immune-altering conditions. Among patients with HZ, the 6-month rate of persistent post-zoster pain was estimated.

Results: Analysis of 90.2 million PY at risk revealed that the incidence of HZ in the total study population was 4.82/1,000 PY. The incidence of HZ was highest among patients with bone marrow or stem cell transplant (43.03 %) followed by solid organ transplant, human immunodeficiency virus infection, and systemic lupus erythematosus [95 % confidence interval (CI) 15.19-17.41 %]. HZ incidence rates were higher among persons on immunosuppressants/chemotherapy than among non-users. In the total study population, HZ incidence increased with age (18-49 years: 3.37/1,000 PY; 65+ years: 8.43/1,000 PY; P < 0.01) and female gender (incidence ratio vs. male 1.39, 95 % CI 1.38-1.40 %). The 6-month rate of persistent post-zoster pain was 4.29 % (95 % CI 4.22-4.36 %), which was higher in patients with the selected conditions.

Conclusions: Despite providing a relatively small fraction of overall HZ cases, persons with immune function-altering conditions make a large contribution to the societal healthcare burden because they have a higher risk of developing HZ and persistent post-zoster pain. These risk factors should be considered in HZ prevention efforts.

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Figures

Fig. 1
Fig. 1
Incidence rate ratio of herpes zoster (HZ) for users of immunosuppressants or chemotherapy (users vs. non-users). BMSCT Bone marrow or stem cell transplant, SOT solid organ transplant, SLE systemic lupus erythematosus, RA rheumatoid arthritis, IBD inflammatory bowel disease, MS multiple sclerosis
Fig. 2
Fig. 2
Incidence rate ratio of HZ for gender (female vs. male). HIV Human immunodeficiency virus infection
See this image and copyright information in PMC

References

    1. Mueller NH, Gilden DH, Cohrs RJ, Mahalingam R, Nagel MA. Varicella zoster virus infection: clinical features, molecular pathogenesis of disease, and latency. Neurol Clin. 2008;26:675–697. doi: 10.1016/j.ncl.2008.03.011. - DOI - PMC - PubMed
    1. White RR, Lenhart G, Singhal PK, Insinga RP, Itzler RF, Pellissier JM, et al. Incremental 1-year medical resource utilization and costs for patients with herpes zoster from a set of US health plans. Pharmacoeconomics. 2009;27:781–792. doi: 10.2165/11317560-000000000-00000. - DOI - PubMed
    1. Drolet M, Levin MJ, Schmader KE, Johnson R, Oxman MN, Patrick D, et al. Employment related productivity loss associated with herpes zoster and postherpetic neuralgia: a 6-month prospective study. Vaccine. 2012;30:2047–2050. doi: 10.1016/j.vaccine.2012.01.045. - DOI - PubMed
    1. Singhal PK, Makin C, Pellissier J, Sy L, White R, Saddier P. Work and productivity loss related to herpes zoster. J Med Econ. 2011;14:639–645. doi: 10.3111/13696998.2011.607482. - DOI - PubMed
    1. Dworkin RH, White R, O’Connor AB, Hawkins K. Health care expenditure burden of persisting herpes zoster pain. Pain Med. 2008;9:348–353. doi: 10.1111/j.1526-4637.2006.00196.x. - DOI - PubMed

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