The sequelae of herpes zoster

Area of Science:

• Epidemiology
• Infectious Diseases
• Public Health

Background:

• The incidence of herpes zoster (shingles) has shown a substantial increase over the past four decades.
• This trend necessitates an investigation into potential changes in the associated complication rates.

Purpose of the Study:

• To evaluate whether the risk of complications from herpes zoster has changed over the last 40 years.
• To assess the impact of age and immune status on herpes zoster complication risk.

Main Methods:

• Automated medical records from a health maintenance organization were screened for herpes zoster diagnosis codes.
• Full-text records were sampled to determine the predictive value of herpes zoster diagnoses.
• Records of patients with complication codes underwent full review to identify and analyze adverse outcomes.

Main Results:

• A 60-day risk of 12% for complications was observed in 859 individuals with herpes zoster, adjusted to 14% after sensitivity analysis.
• The risk of complications increased significantly with age, with individuals over 64 years old having over six times the risk of those under 25.
• Trigeminal rash distribution and conditions associated with immune compromise were identified as risk factors for complications.

Conclusions:

• Despite an apparent rise in herpes zoster incidence, the risk of specific or overall complications has not changed in this population-based sample.
• Advanced age and conditions linked to diminished cellular immunity are associated with a higher likelihood of experiencing complicated herpes zoster.
• These findings underscore the importance of considering age and immune status in managing herpes zoster patients.