Epidemiology and cost of herpes zoster and postherpetic neuralgia in Germany

Ultsch, B.; Köster, Ingrid; Reinhold, Thomas; Siedler, Anette; Krause, Gérard; Icks, Andrea; Schubert, Ingrid; Wichmann, Ole

doi:10.1007/s10198-012-0452-1

Cited by 65 publications

(108 citation statements)

References 53 publications

(73 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The same score can be assigned to multiple endpoints, as different endpoints can be equally significant. 1 Age group should be selected according to the modelling results…”

Section: Severe Local Reactionsmentioning

confidence: 99%

“…The data on epidemiology and the direct and indirect treatment costs of HZ and PHN were taken from SHI billing data in Germany [1,28]. The vaccination costs consist of € 175 per vaccine dose (rote-liste.de, effective: 27 February 2017) and € 7 administration costs (assumption).…”

Section: Input Datamentioning

confidence: 99%

“…In Germany, more than 300,000 persons over the age of 50 develop HZ every year [1]. HZ is caused by a reactivation of the varicella zoster virus (VZV) that remained latent in sensory ganglia after the primary infection.…”

Section: Introductionmentioning

confidence: 99%

“…The primary VZV infection causes chicken pox, and usually occurs years to decades earlier. About 6-18% of HZ cases develop a postherpetic neuralgia (PHN) as the most frequent HZ complication [1]. The symptom of this is chronic pain that lasts months or years and significantly reduces quality of life.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Background paper to the decision not to recommend a standard vaccination with the live attenuated herpes zoster vaccine for the elderly in Germany

2017

Bundesgesundheitsbl

View full text Add to dashboard Cite

“…The same score can be assigned to multiple endpoints, as different endpoints can be equally significant. 1 Age group should be selected according to the modelling results…”

Section: Severe Local Reactionsmentioning

confidence: 99%

Section: Input Datamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Background paper to the decision not to recommend a standard vaccination with the live attenuated herpes zoster vaccine for the elderly in Germany

2017

Bundesgesundheitsbl

View full text Add to dashboard Cite

“…Due to both its painfulness and its duration, PHN has a large impact on the healthrelated quality of life of HZ patients (5). PHN represents a significant proportion of HZ-related morbidity (6) and costs (7). Certain risk factors for the incidence and severity of HZ and subsequent PHN have been identified, such as VZV-specific immunity (8) and old age (6,9,10).…”

mentioning

confidence: 99%

Varicella-Zoster Virus-Derived Major Histocompatibility Complex Class I-Restricted Peptide Affinity Is a Determining Factor in the HLA Risk Profile for the Development of Postherpetic Neuralgia

Meysman

Ogunjimi

Naulaerts

et al. 2015

J Virol

View full text Add to dashboard Cite

Postherpetic neuralgia (PHN) is the most common complication of herpes zoster and is typified by a lingering pain that can last months or years after the characteristic herpes zoster rash disappears. It is well known that there are risk factors for the development of PHN, such as its association with certain HLA alleles. In this study, previous HLA genotyping results were collected and subjected to a meta-analysis with increased statistical power. This work shows that the alleles HLA-A*33 and HLA-B*44 are significantly enriched in PHN patients, while HLA-A*02 and HLA-B*40 are significantly depleted. Prediction of the varicella-zoster virus (VZV) peptide affinity for these four HLA variants by using one in-house-developed and two existing state-of-the-art major histocompatibility complex (MHC) class I ligand prediction methods reveals that there is a great difference in their absolute and relative peptide binding repertoires. It was observed that HLA-A*02 displays a high affinity for an ϳ7-fold-higher number of VZV peptides than HLA-B*44. Furthermore, after correction for HLA allele-specific limitations, the relative affinity of HLA-A*33 and HLA-B*44 for VZV peptides was found to be significantly lower than those of HLA-A*02 and HLA-B*40. In addition, HLA peptide affinity calculations indicate strong trends for VZV to avoid high-affinity peptides in some of its proteins, independent of the studied HLA allele. IMPORTANCE Varicella-zoster virus can cause two distinct diseases: chickenpox (varicella) and shingles (herpes zoster).Varicella is a common disease in young children, while herpes zoster is more frequent in older individuals. A common complication of herpes zoster is postherpetic neuralgia, a persistent and debilitating pain that can remain months up to years after the resolution of the rash. In this study, we show that the relative affinity of HLA variants associated with higher postherpetic neuralgia risk for varicella-zoster virus peptides is lower than that of variants with a lower risk. These results provide new insight into the development of postherpetic neuralgia and strongly support the hypothesis that one of its possible underlying causes is a suboptimal anti-VZV immune response due to weak HLA binding peptide affinity. P rimary infection by varicella-zoster virus (VZV) results in the common childhood disease varicella (chickenpox). VZV persists as a latent infection in dorsal root ganglion cells with minimal gene transcription (1). Clinical reactivation of VZV typically results in a characteristic painful dermatomal rash and is termed shingles or herpes zoster (HZ). Furthermore, HZ patients transmit VZV and thus could cause chickenpox in susceptible individuals, thereby reigniting the epidemiological VZV cycle (2, 3). It is estimated that ϳ10% to 30% of individuals will develop HZ in their lifetimes, with the frequency increasing to 50% for those Ͼ85 years of age (4). For many of these patients, the affected region remains painful for months or, exceptionally, years after the HZ rash reso...

show abstract

Treatment of peripheral neuropathic pain by topical capsaicin: Impact of pre‐existing pain in the QUEPP‐study

Maihöfner

Heskamp

2013

European Journal of Pain

View full text Add to dashboard Cite

BackgroundThis study evaluates the impact of the duration of pre-existing peripheral neuropathic pain on the therapeutic response to the capsaicin 8% cutaneous patch.MethodsThe non-interventional QUEPP (QUTENZA – safety and effectiveness in peripheral neuropathic pain) study evaluated the effectiveness of Qutenza™ in 1044 non-diabetic patients with peripheral neuropathic pain, who received a single application. Follow-up visits were scheduled at weeks 1–2, 4, 8 and 12. A pre-defined co-analysis of changes in average pain intensity was performed based on the duration of pre-existing pain.ResultsIn patients with pre-existing pain for <6 months, the mean relative change of the numeric pain rating scale score on days 7–14 to week 12 versus baseline was −36.6% [4.6 standard error of the mean (SEM); n = 105], −25.1% (1.9 SEM; n = 311) in patients with pain duration of 6 months to 2 years, −22.3% (1.6 SEM; n = 391) in patients with pain for >2–10 years, and −19.2% (2.6 SEM; n = 99) in patients with pain for >10 years. Thirty percent and 50% responder rates were 61.7% and 39.3% in patients with pre-existing pain for <6 months, 42.3% and 23.3% in patients with pain for 6 months to 2 years, 40.9% and 21.6% in patients with pain for >2–10 years, and 32.3% and 14.1% in patients with pain for >10 years.ConclusionsThe highest treatment response to the capsaicin 8% cutaneous patch was observed in patients with a history of pre-existing peripheral neuropathic pain of less than 6 months, suggesting that early initiation of topical treatment might be indicated.

show abstract

Epidemiology and cost of herpes zoster and postherpetic neuralgia in Germany

Abstract: 1Background: After acquiring a varicella-virus-infection, the virus can reactivate and cause herpes zoster

Cited by 65 publications

References 53 publications

Background paper to the decision not to recommend a standard vaccination with the live attenuated herpes zoster vaccine for the elderly in Germany

Background paper to the decision not to recommend a standard vaccination with the live attenuated herpes zoster vaccine for the elderly in Germany

Varicella-Zoster Virus-Derived Major Histocompatibility Complex Class I-Restricted Peptide Affinity Is a Determining Factor in the HLA Risk Profile for the Development of Postherpetic Neuralgia

Treatment of peripheral neuropathic pain by topical capsaicin: Impact of pre‐existing pain in the QUEPP‐study

Contact Info

Product

Resources

About