Abstract
ObjectiveTo understand the disease burden due to Herpes Zoster (HZ) among people aged ≥50 years old in China and provide baseline data for future similar studies, and provide evidence for development of herpes zoster vaccination strategy.MethodsRetrospective cohort study was conducted in 4 townships and one community. A questionnaire was used to collect information on incidence and cost of HZ among people aged ≥ 50 years old.ResultsThe cumulative incidence rate was 22.6/1,000 among people aged ≥ 50 years old. The average annual incidence rate of HZ was 3.43/1,000 among people aged ≥ 50 years old in 2010–2012. Cumulative incidence and average annual incidence rate increased with age: the cumulative incidence of HZ among people aged ≥ 80 years old was 3.34 times of that among 50- years old (52.3/1000vs15.7/1,000); average annual incidence rate rises from 2.66/1,000 among 50- years old to 8.55/1,000 among 80- year old. Cumulative incidence and average annual incidence rate for females were higher than that for males (cumulative incidence, 26.5/1000vs18.7/1,000; annual incidence rate, 3.95/1000vs2.89/1,000). Cumulative incidence and average annual incidence rate in urban were higher than in rural (cumulative incidence, 39.5/1000vs 17.2/1,000; annual incidence rate, 7.65/1000vs2.06/1,000). The hospitalization rate of HZ was 4.53%. And with the increase of age, the rate has an increasing trend. HZ costs 945,709.5 RMB in total, corresponding to 840.6 RMB per patient with a median cost of 385 RMB (interquartile range 171.7–795.6). Factors associated with cost included the first onset year, area, whether hospitalized and whether sequelae left.ConclusionIncidence rate, complications, hospitalization rate and average cost of HZ increase with age. We recommend that the HZ vaccinations should target people aged ≥50 years old if Zoster vaccine is licensed in China.
Highlights
The average annual incidence rate of Herpes zoster (HZ) was 3.43/1,000 among people aged ! 50 years old in 2010–2012
Cumulative incidence and average annual incidence rate increased with age: the cumulative incidence of HZ among people aged ! 80 years old was 3.34 times of that among 50- years old (52.3/1000vs15.7/1,000); average annual incidence rate rises from 2.66/1,000 among 50- years old to 8.55/1,000 among 80- year old
We recommend that the HZ vaccinations should target people aged !50 years old if Zoster vaccine is licensed in China
Summary
Herpes zoster (HZ), a disease characterized by clusters of blisters along the areas innervated by sensory nerve, is caused by varicella-zoster virus (VZV). The incidence of HZ correlates with increasing age, especially people after 50 years old [1,2]. It is estimated that the risks of occurring HZ in people previously infected with varicella are 10%-30% and the severity increases with age [3,4,5,6,7].The annual incidence of HZ in the year 2013, 2012 and 2011 in Guangdong, China was 5.8, 3.4 and 4.1 per 1000 person-years, respectively[8]. The Zoster vaccine was licensed for people at least 50 years of age who had not have prior HZ for the prevention of HZ in Australia and Europe, while target age is at least 60 years of age in the US [9,10,11,12]. In addition current available data in China are mostly focused on treatments, only one study [8] on epidemiology and incidence, and no data on economic burden is available, especially community and population based data
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