The temporal impact of aging on the burden of herpes zoster

Abstract

BackgroundThe risk of Herpes Zoster (HZ) increases with age and various studies have also demonstrated an increasing HZ incidence globally. Simultaneously, the global trend of an aging population has placed a greater burden on the healthcare system. This study aims to estimate the potential burden of HZ over time accounting for the increasing trends of both HZ incidence and global aging.MethodsA recent systematic review on HZ incidence identified studies that evaluated the temporal effects of HZ incidence. Data from the identified studies were extracted to estimate the trend of HZ incidence in the ≥65-year-old age cohort. The incidence rates were estimated up to the year 2030 using two scenarios: a linear extrapolation and a last observation carried forward. Three countries were chosen to perform the analysis on: Australia, Japan and the United States.ResultsThe incidence data from the three countries showed an average annual increase between 2.35 and 3.74% over the time period of the studies selected. The elderly population for the US, Japan and Australia are expected to increase by 55, 10 and 53% respectively by the year 2030 compared to the levels in 2015. Under the first scenario between 2001 and 2030, the number of annual incident cases of HZ in those aged ≥65 years is expected to increase by +343% (293,785 to 1,303,328), +176% (158,616 to 437,867) and +376% (18,105 to 86,268) in the US, Japan and Australia respectively while those for the second scenario are +150%, +83% and +223% respectively. In the US alone, the estimated annual cost of HZ-related cases in the ≥65 age cohort is approximately 4.74 Billion US$ in 2030.ConclusionsThe increasing incidence of HZ coupled with the demographic trends (i.e., aging population and greater life expectancy) in many countries are likely to imply a rising economic burden of HZ on already constrained healthcare budgets.

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

“…Previously, for this same study population we found that IRs for HZ were higher in females compared with males and increased with greater age, and were highest in patients with IC conditions (and in particular those undergoing HSCT, subjects with HM and those with SLE), and somewhat lower in subjects with chronic medical conditions . Those findings are consistent with those from other epidemiological studies which report an increasing incidence of HZ with older age, and also a higher incidence in patients with malignancy, and other IC conditions such as SLE . In the further data we present here, we show that the influence of age and sex is also apparent in patients with different IC and chronic medical conditions.…”

“…The lifetime risk for developing HZ is estimated at 30% . Declining VZV‐specific cell‐mediated immunity, which predisposes an individual to VZV reactivation and clinical HZ, occurs as a result of age‐related “immunosenescence”, which may explain the greater risk and higher incidence of HZ in individuals aged 50 years or more . Incidence and risk is greater in women, in individuals with immunocompromised (IC) medical conditions (e.g., patients with hematological or solid tumors or those receiving immunosuppressive therapies) and also in individuals with certain chronic medical conditions .…”

“…2 Declining VZV-specific cell-mediated immunity, which predisposes an individual to VZV reactivation and clinical HZ, occurs as a result of age-related "immunosenescence", which may explain the greater risk and higher incidence of HZ in individuals aged 50 years or more. 2,6,7 Incidence and risk is greater in women, 2,6 in individuals with immunocompromised (IC) medical conditions (e.g., patients with hematological or solid tumors or those receiving immunosuppressive therapies) and also in individuals with certain chronic medical conditions. 6,[8][9][10][11][12][13][14] Older adults and those with IC conditions (where complications may be more severe) and with chronic medical conditions are also at greater risk of HZ-associated complications, most commonly postherpetic neuralgia (PHN), but also other neurological complications, ocular complications, and disseminated HZ.…”

Cost-effectiveness of an adjuvanted recombinant zoster vaccine in older adults in the United States who have been previously vaccinated with zoster vaccine live

“…2 HZ is a painful and costly condition estimated to result in approximately $1.3 billion in medical care costs and $1.7 billion in indirect costs in the US annually; 3 this burden is projected to rise substantially over the coming years due to aging populations. 4 In 2008, the Advisory Committee on Immunization Practices (ACIP) recommended that adults aged 60+ years old be vaccinated against HZ. 5 A live attenuated zoster vaccine, Zostavax (Zoster Vaccine Live [ZVL]) (currently licensed for use in healthy adults aged 50+ years old), is a one-dose vaccine that utilizes the same Oka strain as in varicella vaccines but at a higher potency.…”

Herpes Zoster Sebagai Pencetus Ketoasidosis Diabetikum (KAD)

“…Pasien geriatrik seperti pada kasus ini memang berisiko lebih tinggi terkena herpes zoster karena beberapa faktor seperti peningkatan penggunaan vaksin varicella, populasi manula yang meningkat, kondisi kronis penyerta, dan meningkatnya penggunaan terapi imunosupresif. 8,9 Terapi antivirus bertujuan untuk mempercepat penyembuhan lesi, mengurangi pembentukan lesi baru, mengurangi pelepasan virus, dan mengurangi nyeri. Terapi antivirus paling bermanfaat pada pasien immunocompromised, berusia > 50 tahun, dengan nyeri atau ruam yang berat.…”