Burden of herpes zoster and postherpetic neuralgia in Japanese adults 60 years of age or older: Results from an observational, prospective, physician practice‐based cohort study

Abstract

Approximately one in three persons will develop herpes zoster during their lifetime, and it can lead to serious complications such as postherpetic neuralgia. However, evidence on burden of herpes zoster and postherpetic neuralgia in Japan is limited. This prospective, observational, multicenter, physician practice‐based cohort study was conducted in Kushiro, Hokkaido, Japan (Clinicaltrials.gov identifier NCT01873365) to assess the incidence and hospitalization rates of herpes zoster, and the proportion, clinical burden and risk factors for postherpetic neuralgia in adults aged 60 years or more. Within the study area, 800 subjects developed herpes zoster and 412 were eligible for the study. Herpes zoster incidence was 10.2/1000 person‐years and higher among women and older subjects. Subjects with herpes zoster required on average 5.7 outpatient consultations. Herpes zoster‐associated hospitalization rate was 3.4% (27/800). The proportion of postherpetic neuralgia and other complications was 9.2% (38/412) and 26.5% (109/412), respectively. Statistically significant association with the development of postherpetic neuralgia was male sex (odds ratio [OR], 2.51; 95% confidence interval [CI], 1.17–5.38), age of 70–74 years (OR, 3.51; 95% CI, 1.09–11.3), immunosuppressive therapy (OR, 6.44; 95% CI, 1.26–32.9), severe herpes zoster pain at first consultation (OR, 3.08; 95% CI, 1.10–8.62) and rash on upper arms (vs no rash on upper arms; OR, 3.46; 95% CI, 1.10–10.9). Considerable herpes zoster and postherpetic neuralgia burden exists among elderly in Japan, and there may be predictive factors at the first visit which could be indicative of the risk of developing postherpetic neuralgia.

The risk of herpes zoster among patients with ankylosing spondylitis: A population‐based cohort study in Taiwan

“…Age is an important risk factor for HZ infection. Many studies show that HR increases in the elderly, especially in patients over 60 years . It was reported that there was an age‐specific decrease in VZV memory CD4 cells, so immunosenescence may be the key cause which leads to the increase of VZV infection and reactivation in the elderly .…”

“…show that HR increases in the elderly, especially in patients over 60 years. 11,13,[20][21][22][23][24] It was reported that there was an age-specific decrease in VZV memory CD4 cells, so immunosenescence may be the key cause which leads to the increase of VZV infection and reactivation in the elderly. 25 Previous studies showed that in Taiwan age is also a major risk factor for HZ.…”

Risk of herpes zoster in the Japanese population with immunocompromising and chronic disease conditions: Results from a claims database cohort study, from 2005 to 2014

“…Herpes zoster (HZ), which is due to the reactivation of latent varicella zoster virus (VZV) within dorsal root/cranial nerve ganglia, presents a substantial clinical and health-care resource utilization burden, both globally 1,2 and in Japan. [3][4][5] HZ typically manifests as an acute blistering rash involving the affected dermatome(s), accompanied by pain, which may be substantial. 1 The lifetime risk for developing HZ is estimated at 30%.…”

Economic Burden of Herpes Zoster and Post-Herpetic Neuralgia in Adults 60 Years of Age or Older: Results from a Prospective, Physician Practice-Based Cohort Study in Kushiro, Japan

“…Four hundred and twelve patients were eligible for the cost analysis. This is the reporting of secondary outcomes for this study that has been previously reported [ 14 ].…”

“…In addition, both healthcare payer costs and societal costs were higher in patients with PHN than HZ patients without any complications. The prospective study conducted in Kushiro, Japan [ 14 ], reported that 10.2/1000 people would develop HZ at ≥ 60 years of age, which would estimate the total annual cases at approximately 430,000 in people aged ≥ 60 years [ 4 ]. Extrapolating our cost data, the estimated total annual economic burden of HZ in Japan would become ¥18,807,613,230 from the healthcare payer perspective and ¥24,453,964,867 from the societal perspective.…”