The incidence of herpes zoster in a United States administrative database

Abstract

BACKGROUND: Few recent studies have reported data on the incidence of herpes zoster (HZ) in U.S. general clinical practice.

Health Care Utilization and Cost Burden of Herpes Zoster in a Community Population

“…[3][4][5] However, most HZ cases (>90%) occur in immunocompetent people. 1,2 Herpes zoster can adversely affect a person's health-related quality of life [6][7][8] because of complications such as eye and other nonpain complications 2 as well as acute and chronic pain (postherpetic neuralgia [PHN]) that can result in severe activity limitations and sleep disturbances. 2,6,9 Claims data have been used to estimate the health care utilization (HCU) and cost of HZ in the United States.…”

“…1,2 Herpes zoster results from reactivation of the varicella-zoster virus, which remains dormant after infection with chickenpox. Declining cellular immunity associated with aging and immunocompromising conditions increase the risk of HZ and HZ complications.…”

Post-Shingles Neuralgia by Any Definition Is Painful, but Is It PHN?

“…Algorithms from other authors have achieved slightly lower sensitivity and positive predictive values. [5][6][7] Whether it is the algorithm or the dataset used that resulted in the improvements is unclear, 8 but administrative data can clearly provide important information about shingles. 5 The claim by Klompas et al to have high sensitivity and positive predictive values for identifying PHN may not be as easily accepted.…”

“…In most longitudinal studies, more than 50% to 75% of pain present at 30 days appears to be gone by 90 days after HZ. [3][4][5][6][7] This means that the prevalence of PHN varies 6-fold based on the definition used.…”

“…Similar algorithms for assessing HZ incidence have been used by others. 5,6 The algorithm developed by Klompas et al 4 to identify HZ is reported to be 98% sensitive with a 93% positive predictive value. Algorithms from other authors have achieved slightly lower sensitivity and positive predictive values.…”