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. 2018 Mar 20;18(1):369.
doi: 10.1186/s12889-018-5247-6.

Epidemiology and long-term disease burden of herpes zoster and postherpetic neuralgia in Taiwan: a population-based, propensity score-matched cohort study

Wan-Hsuan Lu  1   2 , Chih-Wan Lin  1 , Chen-Yu Wang  1   3 , Liang-Kung Chen  4   5 , Fei-Yuan Hsiao  6   7   8
Affiliations

Epidemiology and long-term disease burden of herpes zoster and postherpetic neuralgia in Taiwan: a population-based, propensity score-matched cohort study

Wan-Hsuan Lu et al. BMC Public Health. .

Abstract

Background: The objectives of this study were to characterize the burden of herpes zoster, as well as the longitudinal and incremental changes of healthcare service utilization among individuals with herpes zoster and postherpetic neuralgia (PHN) compared to those without.

Methods: Using the National Health Insurance Research Database (NHIRD), we established a herpes zoster cohort of people diagnosed with herpes zoster between 2004 and 2008 as study cases. Another subset of the NHIRD, which was randomly selected from all elderly beneficiaries between 2004 and 2008 served as a non-herpes-zoster elderly control pool. Each case was then assigned one matched control according to age, gender, index date and propensity score. PHN cases were defined as those with persisting pain for more than 90 days after the onset of herpes zoster.

Results: Between 2004 and 2008, about 0.6 million patients were newly diagnosed with herpes zoster. The incidence increased with age, and most cases were identified during the summer period. Herpes zoster cases were found to have higher consumption of all types of healthcare services in the first year after the index date. Such increases were particularly obvious for patients with PHN, who showed incremental increases on average of 16.3 outpatient visits, 0.4 emergency room visits and 0.24 inpatient admissions per year.

Conclusions: The incidence of herpes zoster increased with age and changed according to the seasons. Patients with herpes zoster were associated with higher healthcare utilization and this increase in healthcare utilization was most obvious for herpes zoster patients with PHN.

Keywords: Disease burden; Epidemiology; Herpes zoster; Postherpetic neuralgia.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the institutional review board of the National Taiwan University Hospital (201,411,050 W), and access to the National Health Insurance Research Database (NHIRD) was permitted by the National Health Research Institutes (NHRI) in Taiwan. Since the identification numbers of all subjects in the NHIRD were encrypted to protect the privacy of the individuals, this study was exempted from full review by the institutional review board and informed consents were waived.

Consent for publication

Not applicable.

Competing interests

FYH, LKC, WHL, and CYW received a research grant sponsored by Merck Sharp & Dohme (I.A.) Corp.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Seasonal variation in number of herpes zoster cases, stratified by age
Fig. 2
Fig. 2
Gender difference of the disease burden in herpes-zoster patients. (a) Proportion of cases with herpes zoster-related admission. (b) Proportion of cases with postherpetic neuralgia
Fig. 3
Fig. 3
Incremental changes of healthcare utilization in the 3-year follow-up period. (a) Change of number of outpatient visits (/person/year). (b) Change of number of emergency room visits (/person/year). (c) Change of number of inpatient admissions (/person/year)
See this image and copyright information in PMC

References

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