The Unknown Health Burden of Herpes Zoster Hospitalizations: The Effect on Chronic Disease Course in Adult Patients ≥50 Years.

Maria Francesca Piazza,Cecilia Trucchi,Daniela Amicizia,Simona Simonetti,Andrea Orsi,Giancarlo Icardi,Filippo Ansaldi,Paolo Romairone,Matteo Astengo,Chiara Paganino

doi:10.3390/vaccines8010020

Abstract

The effect of severe Herpes Zoster (HZ) on chronic diseases is a component of the real burden of this vaccine-preventable disease that is not commonly considered. A retrospective cohort study was conducted to assess the health burden of severe HZ in adults ≥50 years residing in Liguria Region from 2015 to 2017. Subjects hospitalized with and without HZ were matched (1:6 ratio). 437 subjects in the HZ cohort and 2622 subjects in the non-HZ cohort were enrolled. Previous immunodeficiency, autoimmune, and rare diseases are identified as main chronic conditions related to HZ hospitalization. Higher incidences of autoimmune (1.4% vs. 0.22%, p = 0.002) and gastrointestinal (7.04% vs. 3.62%, p = 0.015) diseases after hospitalization were observed in the HZ cohort compared to the non-HZ cohort. Significantly higher incidences were found after hospitalization versus the previous period for cardiovascular diseases (11.17% vs. 2.09%, p < 0.001), cerebral vasculopathy (6.13% vs. 0.60%, p < 0.001), non-arrhythmic myocardiopathy (4.31% vs. 0.59%, p = 0.002), and neuropathy (2.62% vs. 0.56%, p = 0.033). The HZ cohort showed a relative risk 10-fold higher for cerebral vasculopathy, 5-fold higher for cardiovascular diseases, and 7-fold higher for non-arrhythmic myocardiopathy. HZ causes a substantial impact on the chronic conditions. These data could suggest an implementation of HZ vaccination programs in the elderly and in high-risk groups.

Highlights

Herpes Zoster (HZ) is the clinical manifestation of reactivation of varicella-zoster virus remained latent in dorsal root or cranial nerve sensory ganglia after primary infection
The most common complications related to HZ are post-herpetic neuralgia (PHN), a long-lasting pain that does not end with the disappearance of the rash, but persists for some weeks, and even months or years; ocular lesions involving the ophthalmic division of the trigeminal nerve; neurological sequelae; and visceral inflammation [5,7,8,9]
The overall HZ hospitalization rate amounted to 18.16 cases per from

Summary

Introduction

Herpes Zoster (HZ) is the clinical manifestation of reactivation of varicella-zoster virus remained latent in dorsal root or cranial nerve sensory ganglia after primary infection. The most common complications related to HZ are post-herpetic neuralgia (PHN), a long-lasting pain that does not end with the disappearance of the rash, but persists for some weeks, and even months or years; ocular lesions involving the ophthalmic division of the trigeminal nerve; neurological sequelae; and visceral inflammation [5,7,8,9]. Severe cases with these complications often require hospitalization [6,10,11]

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Conclusion