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. 2021 Jun 3;17(6):1714-1732.
doi: 10.1080/21645515.2020.1847582. Epub 2021 Mar 2.

A systematic literature review of herpes zoster incidence worldwide

Désirée van Oorschot  1 , Hilde Vroling  2 , Eveline Bunge  2 , John Diaz-Decaro  3 , Desmond Curran  1 , Barbara Yawn  4
Affiliations

A systematic literature review of herpes zoster incidence worldwide

Désirée van Oorschot et al. Hum Vaccin Immunother. .

Abstract

We conducted a systematic review to characterize the incidence rate of herpes zoster (HZ) in the general population, specifically in individuals ≥50 years of age. A total of 69 publications were included in the review. We found a cumulative incidence of HZ ranging from 2.9-19.5 cases per 1,000 population and an incidence rate of HZ ranging from 5.23-10.9 cases per 1,000 person-years. The cumulative incidence (3.22-11.2 versus 2.44-8.0 cases per 1,000 population) and incidence rates (6.05-12.8 versus 4.30-8.5 cases per 1,000 person-years) were higher in females than males. Studies revealed a trend of increasing incidence of HZ with increasing age and over time. Variations in incidence estimates can be attributed to the various study designs, case ascertainments, age distributions of the population and year of the study. HZ is associated with a substantial disease burden and is expected to increase due to population aging.

Keywords: Incidence; adults; epidemiology; herpes zoster; review; shingles; vaccination.

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Figures

Figure 1.
Figure 1.
PRISMA diagram
Figure 2.
Figure 2.
Distribution of publications (N = 69) by (A) Study design, (B) Case identification method, (C) Incidence data stratification. The total number of studies add up to 77 studies as 8 studies utilized more than one method to detect HZ (see Table 1)
Figure 3.
Figure 3.
Overall HZ incidence in the general population ≥50 years by country (A) Cumulative incidence (B) Incidence rate
Figure 4.
Figure 4.
Cumulative HZ incidence (number of new HZ cases per 1,000 population) by (A) Time, (B) Age (region).Source: Table 1Figure 2A: Studies with at least 2 years of data are depicted*Incidence rate (number of HZ cases per 1,000 person-years) converted to cumulative incidence (number of HZ cases per 1,000 population)HZ, herpes zosterNote: While 42 publications reported cumulative incidence, only 30 of these presented an overall incidence for those ≥50 years and are depicted here
Figure 4.
Figure 4.
(Continued)
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention . Shingles (herpes zoster) overview. 2018. Accessed 2020 April28. https://www.cdc.gov/shingles/about/index.html
    1. Harpaz R, Ortega-Sanchez IR, Seward JF.. Advisory committee on immunization practices centers for disease c, prevention. prevention of herpes zoster: recommendations of the advisory committee on immunization practices (ACIP). MMWR Recomm Rep. 2008;57:1–30. quiz CE32-34. - PubMed
    1. Drolet M, Brisson M, Levin MJ, Schmader KE, Oxman MN, Johnson RW, Camden S, Mansi JA. A prospective study of the herpes zoster severity of illness. Clin J Pain. 2010;26:656–66. - PubMed
    1. Kawai K, Gebremeskel BG, Acosta CJ. Systematic review of incidence and complications of herpes zoster: towards a global perspective. BMJ Open. 2014;4:e004833. doi:10.1136/bmjopen-2014-004833. - DOI - PMC - PubMed
    1. Volpi A. Severe complications of herpes zoster. Herpes. 2007;14:35–39. - PubMed

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