Recurrence Rate of Herpes Zoster and Its Risk Factors: a Population-based Cohort Study

Abstract

BackgroundHerpes zoster (HZ) is generally thought to occur once in a lifetime and recurrence is considered to be limited to immunocompromised individuals. Although HZ recurrence rates seem to be increasing, there have been few studies exploring these rates in the general population. We investigated the recurrence rate and associated risk factors in the general population.MethodsWe used the population-based samples of the National Health Insurance Service database to identify cases of initial HZ episodes from January 1, 2002 to December 31, 2013. We also followed up on these cases through December 31, 2013 to identify recurrence.ResultsOverall, the incidence rate of HZ is 5.1 per 1,000 person years and the recurrence rate is 12.0 per 1,000 person years. There were 2,100 recurrent cases out of 39,441 initial episodes with 4.4 years of the mean follow-up period. We identified significant risk factors for recurrence such as old age (51–70 years) (hazard ratio [HR], 1.447; 95% confidence interval [CI], 1.311–1.598), women (1.476; 1.345–1.619), zoster-related pain (ZRP) longer than 30 days (cases of ZRP lasting 31–90 days [1.200; 1.042–1.383], and ZRP lasting longer than 90 days [2.293; 1.990–2.643]). Concurrent hematologic malignancies (2.864; 1.929–4.251), autoimmune diseases (1.466; 1.252–1.715), dyslipidemia (1.390; 1.263–1.530), and hypertension (1.222; 1.107–1.350) were also significant risk factors.ConclusionOur results suggest that the recurrence of HZ is much more common than generally expected, and that the associated risk factors can play an important role in predicting recurrence.

Burden of Herpes Zoster in Adult Patients with Underlying Conditions: Analysis of German Claims Data, 2007–2018

“…In most individuals, HZ occurs only once in a lifetime. However, there is evidence that HZ can reoccur, especially in those with an UC [ 18 ]. Although information on HZ recurrence is critical for assessing the comprehensive burden of disease caused by HZ, such evidence is limited, as existing studies mostly focus on short follow-up periods and/or small sample sizes and do not consider the recurrence rates of UCs [ 19 , 20 ].…”

The efficacy of selective nerve root block for the long-term outcome of postherpetic neuralgia

“…There are a few study limitations. First, the recurrence incidence of HZ is 12.0 per 1,000 person years with 4.4 year of the mean follow-up period, and ZRP lasting longer than 90 days, which may indicate the presence of PHN, is significantly associated with the recurrence of zoster [15]. However, in the present study, we didn’t evaluate the recurrence of HZ on either the original or a new dermatome area.…”

Herpes zoster recurrence within 1 month: A case report

“…Old age and chronic disease are some of the main factors associated with HZ relapse. 5 In this case report, the patient had a history of occasional spikes in blood glucose levels.…”