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Review
. 2015 Jul;3(4):109-20.
doi: 10.1177/2051013615599151.

Herpes zoster epidemiology, management, and disease and economic burden in Europe: a multidisciplinary perspective

Robert W Johnson  1 , Marie-José Alvarez-Pasquin  2 , Marc Bijl  3 , Elisabetta Franco  4 , Jacques Gaillat  5 , João G Clara  6 , Marc Labetoulle  7 , Jean-Pierre Michel  8 , Luigi Naldi  9 , Luis S Sanmarti  10 , Thomas Weinke  11
Affiliations
Review

Herpes zoster epidemiology, management, and disease and economic burden in Europe: a multidisciplinary perspective

Robert W Johnson et al. Ther Adv Vaccines. 2015 Jul.

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] Ther Adv Vaccines. 2016 Jan;4(1-2):32. doi: 10.1177/2051013616634209. Epub 2016 Jan 1. Ther Adv Vaccines. 2016. PMID: 27551430 Free PMC article.

Abstract

Herpes zoster (HZ) is primarily a disease of nerve tissue but the acute and longer-term manifestations require multidisciplinary knowledge and involvement in their management. Complications may be dermatological (e.g. secondary bacterial infection), neurological (e.g. long-term pain, segmental paresis, stroke), ophthalmological (e.g. keratitis, iridocyclitis, secondary glaucoma) or visceral (e.g. pneumonia, hepatitis). The age-related increased incidence of HZ and its complications is thought to be a result of the decline in cell-mediated immunity (immunosenescence), higher incidence of comorbidities with age and social-environmental changes. Individuals who are immunocompromised as a result of disease or therapy are also at increased risk, independent of age. HZ and its complications (particularly postherpetic neuralgia) create a significant burden for the patient, carers, healthcare systems and employers. Prevention and treatment of HZ complications remain a therapeutic challenge despite recent advances. This is an overview of the multidisciplinary implications and management of HZ in which the potential contribution of vaccination to reducing the incidence HZ and its complications are also discussed.

Keywords: herpes zoster; herpes zoster diagnosis; herpes zoster treatment; herpes zoster vaccination; multidisciplinary management; postherpetic neuralgia.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: All authors received writing assistance from 3E Pharma Consultancy and MediCom Consult funded by Sanofi Pasteur MSD. Robert W. Johnson (lead author): has consulted and lectured for Sanofi Pasteur MSD and consulted for GSK, received writing assistance from 3E Pharma Consultancy and MediCom Consult and received travel expenses and subsistence to attend a meeting with the authors of this paper but no honorarium or consultancy fee was received. Marie-José Alvarez-Pasquin: received fees for participation at a workshop as an expert from Sanofi Pasteur MSD. Marc Bijl: received fees for participation at a workshop as an expert from Sanofi Pasteur MSD, a research grant from Sanofi Pasteur MSD. Elisabetta Franco: has consulted and lectured for Sanofi Pasteur MSD, GSK, Novartis and Pfizer, and received reimbursement of expenses but no honorarium or consultancy fee. Jacques Gaillat: received fees for participation at a workshop as an expert from Sanofi Pasteur MSD. João Gorjão Clara: received fees for participation in Advisory Board Meeting as an expert in Geriatrics from Sanofi Pasteur MSD, Speaker fees for Menarinni and Sanofi Pasteur MSD. Marc Labetoulle: Reimbursement of expenses and fees for advisory boards and speakers bureau from Alcon, Allergan, Bausch & Lomb, Sanofi Pasteur MSD, Santen, Thea. Jean-Pierre Michel: has been an invited speaker for Merck, Pfizer vaccines and SPMSD. Luigi Naldi: received fees for participation at a workshop as an expert from Sanofi Pasteur MSD. Luis Salleras Sanmarti: received fees for participation in round tables sponsored by Sanofi Pasteur MSD. Thomas Weinke: received fees for advisory boards or as a speaker from GSK, Novartis Vaccines, Sanofi Pasteur MSD.

Figures

Figure 1.
Figure 1.
Results from 12 countries showing the risk of developing HZ increases with age, starting at about 50 years old [de Melker et al. 2006; Gauthier et al. 2009; Stein et al. 2009; Toyama and Shiraki, 2009; Gialloreti et al. 2010; Gonzalez Chiappe et al. 2010; Lin et al. 2010; Tanuseputro et al. 2011; Ultsch et al. 2013a; Weitzman et al. 2013; Yawn and Gilden, 2013; Esteban-Vasallo et al. 2014].
Figure 2.
Figure 2.
Overall incidence of herpes zoster (HZ)-related hospitalizations and outpatient visits and medically attended HZ as a function of age in Canada [Tanuseputro et al. 2011].
See this image and copyright information in PMC

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