Herpes zoster in outpatient departments of healthcare centers in India: a review of literature

Abstract

In India, although incidence of Herpes zoster has not been assessed, regional cases have been reported. We revisited the peer-reviewed literature on clinical cases of HZ to depict the trends in population characteristics, disease presentation, and predisposing factors for the disease in India. Systematically conducted literature search yielded 27 studies, published between January 2011 and May 2020, reporting 3124 HZ clinical cases, with high proportions in older adults (>50 years of age: 15.0-81.3%). Thoracic dermatome was consistently reported as the most frequent site affected by HZ (38.9-71.0%). Postherpetic neuralgia and secondary bacterial infections were the two most frequent complications (10.2-54.7% and 3.5-21.0%, respectively). Despite the paucity of data and gaps in the reporting of HZ cases, available evidence indicate that the disease causes an important burden to older adults in India, suggesting that preventive strategies, along with recommendations to healthcare practitioners, can help mitigate the burden of HZ.

Clinico-Demographic Profiles of Herpes Zoster Cases in Patients With and Without COVID-19 Infection During the Pandemic: A Retrospective Analysis of 32 Cases

“…The exact duration of the HZ illness on presentation could not be ascertained in all cases, but it was observed that many patients presented late, probably because of limited availability and use of healthcare facilities for non-COVID-19 illnesses during the pandemic. Otherwise, our cohort's outpatient prevalence rate of HZ, complications noted, and age distributions were similar to the historical cases presented in the literature [14]. However, the lesions were predominantly located in our cohort's head and neck dermatome compared to the thoracic dermatome noted in the review of 3124 HZ clinical cases by Patki et al [14].…”

“…Otherwise, our cohort's outpatient prevalence rate of HZ, complications noted, and age distributions were similar to the historical cases presented in the literature [14]. However, the lesions were predominantly located in our cohort's head and neck dermatome compared to the thoracic dermatome noted in the review of 3124 HZ clinical cases by Patki et al [14].…”

Proceedings of the expert consensus group meeting on herpes zoster disease burden and prevention in India: An opinion paper

“…Notably, the average HZ incidence was reported to be 5.0 per 1000 person-years (PY) in Asia. 6 , 7 On grouping based on age, the incidence values were estimated to be 2.0–3.1, 4.3–5.2, and 7.4–13.8 per 1000 PY in those aged 0–20, 20–50, and >50 years of age, respectively. 6 , 7 Studies also indicated that the geographic location had minimal impact on HZ incidence, which was comparable to different regions of the world.…”

“… 6 , 7 On grouping based on age, the incidence values were estimated to be 2.0–3.1, 4.3–5.2, and 7.4–13.8 per 1000 PY in those aged 0–20, 20–50, and >50 years of age, respectively. 6 , 7 Studies also indicated that the geographic location had minimal impact on HZ incidence, which was comparable to different regions of the world. 6 , 8–11 A systematic review of HZ cases in India reported a range of 18 to 938 clinical HZ cases between January 2011 and May 2020, with the majority of cases seen in adults >50 years of age.…”

“…In India, HZ is not a notifiable disease and there is a lack of comprehensive evidence which describes the incidence and healthcare burden of the disease. 6 Studies in India suggest that majority of the cases were observed in patients >50 years of age, with PHN and secondary bacterial infections being the most commonly reported complications. 6 Given the lack of information on the clinical profile of HZ in India, the limited available data suggests that HZ could be a major health burden to the elderly population in the country.…”