Herpes Zoster In Taiwan Research Articles

Exploring the association between chronic prostatitis and the risk of herpes zoster in a cohort study in Taiwan.

The aim of the cohort research was to study the association between chronic prostatitis and the probability of herpes zoster in Taiwan. Using the National Health Insurance Research Database (NHIRD) of Taiwan, we selected male persons newly diagnosed with chronic prostatitis aged 20-84 years between 2013 and 2020. These male persons were then matched with a non-prostatitis group who did not have a diagnosis of prostatitis by using 1:1 propensity score matching on age and relevant comorbidities. All participants were observed either until a new diagnosis of herpes zoster was noted or until the completion of the study period in 2020. Cox proportional hazards regression analysis was employed to study the hazard ratio (HR) and 95% confidence interval (CI) for the risk of herpes zoster associated with chronic prostatitis. A total of 69 239 participants with chronic prostatitis and 69 239 participants with non-prostatitis were included in the analysis. The incidence rate of herpes zoster was higher in participants with chronic prostatitis compared to the non-prostatitis group (8.03 per 1000 person-years for chronic prostatitis group versus 4.74 per 1000 person-years for non-prostatitis group, incidence rate ratio = 1.69, and 95%CI = 1.59-1.81). After adjusting for co-variables, participants with chronic prostatitis were found to have a higher risk of developing herpes zoster compared to the non-prostatitis group (adjusted HR = 1.69, 95%CI = 1.59-1.81, and p < 0.001). This cohort research suggests that people with chronic prostatitis may have a greater risk of developing herpes zoster compared to the non-prostatitis group in Taiwan. Preventive strategies, such as the administration of the herpes zoster vaccine, might be beneficial in people with chronic prostatitis.

Association between cirrhosis and herpes zoster in a cohort study in Taiwan.

The aim of the study was to assess if an association exists between cirrhosis and herpes zoster in Taiwan. A retrospective cohort study was designed to analyse the 2000-2013 claim dataset of 1 million insured residents who were randomly sampled from the Taiwan National Health Insurance Program. In total, 16190 subjects aged 20-84years old with newly diagnosed cirrhosis since 2000 to 2012 were identified as the cirrhosis group and 16190 sex- and age-matched subjects without cirrhosis were selected as the non-cirrhosis group. Both cirrhosis and non-cirrhosis groups were followed until a new diagnosis of herpes zoster was made or until the end of 2013. The multivariable Cox proportional hazard regression model was applied to calculate the hazard ratio (HR) and 95% confidence interval (CI) for herpes zoster associated with cirrhosis. The incidence rate of herpes zoster was 1.08-fold greater in the cirrhosis group than the non-cirrhosis group (8.33 vs 7.69 per 1000 person-years, 95%CI 1.02-1.15). After adjusting for confounders, the adjusted HR of herpes zoster was 1.11 (95% CI 1.004-1.24) for the cirrhosis group compared with the non-cirrhosis group. The adjusted HR increased to 1.33 (95% CI 1.02-1.74) for the decompensated cirrhosis group compared with the non-cirrhosis group. Cirrhosis is associated with a small but significant increase in the risk of herpes zoster. Given that the risk of herpes zoster is small and the expense of herpes zoster vaccination is high, whether cirrhotic persons need to be vaccinated should assess the balance of cost and benefit.

The impacts of ambient temperature and ultraviolet radiation on the incidence of herpes zoster: An ecological study in Taiwan.

The aim of the study was to examine the relationship between ambient temperature, ultraviolet radiation, and the development of herpes zoster in Taiwan. An ecological study was conducted to analyse the database of the Taiwan National Health Insurance Programme. Participants aged ≥20years with newly diagnosed herpes zoster between 2003 and 2012 were selected for analysis. The monthly incidence rate of herpes zoster was measured between 2003 and 2012. Monthly average ambient temperature in Celsius (°C) between 2003 and 2012 was measured according to the official database of the Central Weather Bureau in Taiwan. Monthly accumulated ultraviolet radiation (MJm-2 ) between 2003 and 2012 was measured according to the official database of the Environmental Protection Administration in Taiwan. The overall incidence rates of herpes zoster ranged from 2.54 to 5.67 per 10000 persons per month from 2003 to 2012.The monthly average ambient temperature was higher and the monthly accumulated ultraviolet radiation was stronger from May to October. The incidence rates of herpes zoster seemed to be high during the period of high ambient temperature and strong ultraviolet radiation (from May to October).Whenever ambient temperature increased 1°C per month, the incidence rate of herpes zoster increased by 0.072 per 10,000 persons per month. Whenever ultraviolet radiation increased 1MJm-2 per month, the incidence rate of herpes zoster increased by 0.313 per 10000 persons per month. There is a significant association between ambient temperature, ultraviolet radiation, and the development of herpes zoster in Taiwan. The incidence rate of herpes zoster is high during the period of high ambient temperature and strong ultraviolet radiation. Low ambient temperature and weak ultraviolet radiation might be beneficial for the prevention of herpes zoster.

Risk of herpes zoster among patients with predialysis chronic kidney disease in a cohort study in Taiwan

Patients on chronic dialysis are at risk of developing herpes zoster, but little systematic research focuses on the association between predialysis chronic kidney disease and herpes zoster. The objective of the study was to explore the association between predialysis chronic kidney disease and herpes zoster in Taiwan. A nation-based retrospective cohort study was performed using the 2005-2012 database of the Taiwan National Health Insurance Program. There were 16655 subjects aged 20-84years with newly diagnosed predialysis chronic kidney disease as the study group and 33310 randomly selected subjects without chronic kidney disease as the comparison group. Both groups were matched with sex, age, comorbidities and the year of the index date. The incidence rates of herpes zoster in both groups were calculated. The multivariable Cox proportional hazards regression model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for herpes zoster associated with predialysis chronic kidney disease. The overall incidence rate of herpes zoster was 1.4-fold higher in the predialysis chronic kidney disease group than that in the non-chronic kidney disease group (8.76 vs 6.27 per 1000 person-years, 95% CI 1.27-1.54; P<.001). After controlling for co-variables, the adjusted HR of herpes zoster was 1.38 (95% CI 1.25-1.53; P<.001) for subjects with predialysis chronic kidney disease compared with non-chronic kidney disease subjects. The adjusted HR increased to 1.65 for subjects with predialysis chronic kidney disease and with any comorbidity (95% CI 1.42-1.92; P<.001). Patients with predialysis chronic kidney disease correlate with approximately 1.4-fold increased hazard of developing herpes zoster.

Splenectomy associated with increased risk of herpes zoster in a population-based cohort study.

No systematic research focuses on the association between splenectomy and herpes zoster. This study aimed to investigate the association between splenectomy and herpes zoster in Taiwan. A population-based cohort study was conducted using the database of Taiwan National Health Insurance Program. There were 640 individuals aged 20-84 years who were newly diagnosed with splenectomy in 2000-2012 as the splenectomy group and 2546 sex-matched and age-matched individuals without splenectomy as the nonsplenectomy group. The incidence of herpes zoster at the end of 2013 was estimated. The multivariable Cox proportional hazards regression model was used to estimate the hazard ratio and 95% confidence interval (CI) for herpes zoster associated with splenectomy. The overall incidence of herpes zoster was 1.41-fold higher in the splenectomy group than in the nonsplenectomy group (11.3 vs. 8.05 per 1000 person-years, 95% CI 1.11-1.78). After multivariable adjustments, the adjusted hazard ratio of herpes zoster was 1.57 for individuals with splenectomy (95% CI 1.08-2.29), compared with individuals without splenectomy. Individuals with splenectomy are associated with 1.57-fold increased risk for developing herpes zoster in Taiwan. Vaccination against herpes zoster may be considered among these high-risk individuals.

Real-world database investigating the association between diabetes mellitus and herpes zoster in Taiwan.

Little evidence is available about the correlation between diabetes mellitus and herpes zoster in Taiwan. This study aimed to investigate the correlation between diabetes mellitus and herpes zoster in Taiwan.A population-based cohort study was conducted using the database of Taiwan National Health Insurance Program. There were 27,369 subjects aged 20 to 84 years with newly diagnosed diabetes mellitus from 2000 to 2012 as the diabetes mellitus group and 107,705 sex- and age-matched subjects without diabetes mellitus as the nondiabetes mellitus group. The incidence of herpes zoster at the end of 2013 was estimated. The multivariable Cox proportional hazards regression model was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) of herpes zoster associated with diabetes mellitus.The overall incidence of herpes zoster was 1.16-fold higher in the diabetes mellitus group than the nondiabetes mellitus group (7.85 vs 6.75 per 1000 person-years, 95% CI 1.12–1.20). After adjustment for co-variables, the adjusted HR of herpes zoster was 1.17 for subjects with diabetes mellitus (95% CI 1.10–1.23), compared with subjects without diabetes mellitus.Patients with diabetes mellitus are associated with 1.17-fold increased risk for developing herpes zoster.

Chronic pancreatitis correlates with increased risk of herpes zoster in a population-based retrospective cohort study.

The association between chronic pancreatitis and herpes zoster has not been fully investigated. The objective of the study was to investigate whether there is an association between chronic pancreatitis and herpes zoster in Taiwan. Using the claim data of the Taiwan National Health Insurance Program, we identified 1,545 participants aged 20-84years with a new diagnosis of chronic pancreatitis from 2000 to 2012 as the chronic pancreatitis group. We selected 6,022 sex-matched and age-matched participants without chronic pancreatitis as the non-chronic pancreatitis group. The incidence of herpes zoster at the end of 2013 was measured. The multivariable Cox proportional hazards regression model was used to measure the hazard ratio (HR) and 95% confidence interval (CI) for herpes zoster associated with chronic pancreatitis. The overall incidence of herpes zoster was 1.34-fold greater in the chronic pancreatitis group than the non-chronic pancreatitis group (6.22 vs. 4.63 per 1,000 person-years, 95% CI 1.16-1.57). After controlling for confounding factors, the adjusted HR of herpes zoster was 1.35 (95% CI 1.01-1.82) for the chronic pancreatitis group, compared with the non-chronic pancreatitis group. Chronic pancreatitis correlates with 1.35-fold increased risk of herpes zoster. From a view of primary prevention, we suggest that patients with chronic pancreatitis should receive herpes zoster vaccination.

Case-control study examining the association between herpes zoster and oral corticosteroids use in older adults.

Little research focuses on the association between herpes zoster and oral corticosteroids use in older adults. The aim of the study was to explore this issue. We performed a case-control study using the database of the Taiwan National Health Insurance Program. There were 10,912 participants aged 65years and older with newly diagnosed herpes zoster in 2000-2013 as the cases. We randomly selected 42,676 sex-matched and age-matched participants without herpes zoster as the controls. Ever use of oral corticosteroids was defined as participants who at least had a prescription for oral corticosteroids before the index date. Never use was defined as participants who did not have a prescription for oral corticosteroids before the index date. The odds ratio (OR) and 95% confidence interval (CI) for herpes zoster associated with oral corticosteroids use were estimated using the logistic regression model. The adjusted OR of herpes zoster was 3.13 for participants with ever use of oral corticosteroids (95% CI 2.84-3.46), compared with never use. In a further analysis, the adjusted ORs of herpes zoster were 3.10 for cumulative duration of oral corticosteroids use < 12months (95% CI 2.81-3.42) and 3.65 for cumulative duration ≥ 12months (95% CI 3.20-4.18). Older adults with oral corticosteroids use are associated with a threefold increase in odds of herpes zoster in Taiwan. There is a duration-related effect of oral corticosteroids use on the risk of herpes zoster.

A nationwide population-based cohort study to identify the correlation between heart failure and the subsequent risk of herpes zoster.

BackgroundThe association between heart failure (HF) and herpes zoster has rarely been studied. We investigated the hypothesis that HF may increase the risk of herpes zoster in Taiwan using a nationwide Taiwanese population-based claims database.MethodOur study cohort consisted of patients who received a diagnosis of HF in 2001 ~ 2009 (N = 4785). For a comparison cohort, three age- and gender-matched control patients for every patient in the study cohort were selected using random sampling (N = 14,355). All subjects were tracked for 1 year from the date of cohort entry to identify whether or not they had developed herpes zoster. Cox proportional-hazard regressions were performed to evaluate 1-year herpes zoster-free survival rates.ResultsThe main finding of this study was that patients with HF seemed to be at an increased risk of developing herpes zoster. Of the total patients, 211 patients developed herpes zoster during the 1-year follow-up period, among whom 83 were HF patients and 128 were in the comparison cohort. The adjusted hazard ratio (AHR) of herpes zoster in patients with HF was higher (AHR: 2.07; 95% confidence interval (CI): 1.54 ~ 2.78; p < 0.001) than that of the controls during the 1-year follow-up. Our study also investigated whether HF is a gender-dependent risk factor for herpes zoster. We found that male patients with HF had an increased risk of developing herpes zoster (AHR: 2.30 95% CI: 1.51 ~ 3.50; p < 0.001).ConclusionsThe findings of our population-based study suggest that patients with HF may have an increased risk of herpes zoster. These health associations should be taken into consideration, and further studies should focused on the cost-effectiveness of the herpes zoster vaccine should be designed for HF patients.

Herpes zoster-associated severity and duration of pain, health-related quality of life, and healthcare utilization in Taiwan: a prospective observational study.

To assess the severity and duration of herpes zoster (HZ)-associated pain (ZAP) and its impact on quality of life (QoL) and healthcare utilization (HCRU) from a patient perspective in routine care in Taiwan. A prospective, observational, single-cohort study was conducted in five centers across Taiwan. Patients were recruited at different time points during their HZ episode and were followed for ≤180days. ZAP was assessed with the Initial Zoster Impact Questionnaire and the Zoster Brief Pain Inventory, QoL with the EQ-5D, and HCRU with a simple questionnaire. A total of 150 patients were included with a mean age of 64.9years and mean time since rash onset of 18.8days. Prodromal pain was experienced by 64.7% of patients, of whom 91.8% reported moderate-to-severe pain. At enrollment, 98.0% of patients experienced ZAP. Mean±SD worst pain score decreased from 5.95±3.09 at enrollment to 2.65±2.98 at 30days and 0.28±0.83 at 180days. Postherpetic neuralgia was observed in 20.7% of patients. Mean±SD EQ-5D score significantly decreased (P<0.001) from 0.91±0.16 before rash onset to 0.67±0.18 after rash onset, showing significant QoL deterioration up to 60days. The impact of HZ on QoL and pain severity was similar across age groups. Significant HCRU was observed including visits to the doctor (83.3% of patients), specialist (30.7%), emergency department (24.7%), physiotherapist (23.3%), and hospitalizations (20.7%). Severe morbidity and significant HCRU are associated with HZ in Taiwan, supporting the need for early intervention and preventive strategies to reduce the HZ-associated burden of illness.

Non-Parametric and Adaptive Modelling of Dynamic Periodicity and Trend with Heteroscedastic and Dependent Errors

SummaryPeriodicity and trend are features describing an observed sequence, and extracting these features is an important issue in many scientific fields. However, it is not an easy task for existing methods to analyse simultaneously the trend and dynamics of the periodicity such as time varying frequency and amplitude, and the adaptivity of the analysis to such dynamics and robustness to heteroscedastic dependent errors are not guaranteed. These tasks become even more challenging when there are multiple periodic components. We propose a non-parametric model to describe the dynamics of multicomponent periodicity and investigate the recently developed synchro-squeezing transform in extracting these features in the presence of a trend and heteroscedastic dependent errors. The identifiability problem of the non-parametric periodicity model is studied, and the adaptivity and robustness properties of the synchro-squeezing transform are theoretically justified in both discrete and continuous time settings. Consequently we have a new technique for decoupling the trend, periodicity and heteroscedastic, dependent error process in a general non-parametric set-up. Results of a series of simulations are provided, and the incidence time series of varicella and herpes zoster in Taiwan and respiratory signals observed from a sleep study are analysed.

The incidence of varicella and herpes zoster in Taiwan during a period of increasing varicella vaccine coverage, 2000–2008

The introduction and the widespread use of the varicella vaccine in Taiwan has led to a 75-80% decrease in the incidence of varicella in children. However the vaccine's long-term impact on the incidence of herpes zoster (HZ) has attracted attention. By controlling gender, underlying diseases, and age effects, a Poisson regression was applied on the 2000-2008 chart records of 240 000 randomly selected residents who enrolled in the Universal National Health Insurance. The results show that, as the vaccine coverage in children increases, the incidence of varicella decreases. However, the incidence of HZ increased even before the implementation of the free varicella vaccination programme in 2004, particularly in females. The increase in the incidence of HZ cannot be entirely and directly attributed to the widespread vaccination of children. Continuous monitoring is needed to understand the secular trends in HZ before and after varicella vaccination in Taiwan and in other countries.

Disease burden and epidemiology of herpes zoster in pre-vaccine Taiwan

Herpes zoster, a common disease, has an important impact on the health of adults, particularly the elderly, and the health system. This study evaluated the disease burden and epidemiological characteristics of herpes zoster in Taiwan. Using herpes zoster-related ICD-9-CM codes used on Taiwan's National Health Insurance claims, we analyzed overall and age group differences in incidence, complications, utilization of healthcare facilities, lengths of stay, and cost of their medical care in Taiwan's population from 2000 to 2005. The overall annual incidence of zoster was 4.97 cases per 1000 people, with women having a significantly higher incidence than men (5.20 per 1000 vs. 4.72 per 1000, p < 0.001). The incidence increased stepwise with age, with 5.18 cases per 1000 in people 40–50 years old, 8.36 in those 50–60, 11.09 in those 60–70, and 11.77 in those above 70 years old. The estimated lifetime risk of developing herpes zoster was 32.2%. Zoster-related hospitalizations and medical cost per patient increased with age. In conclusion, about two-thirds of Taiwan's zoster cases occur in adults older than 40 years old and about one-third of the population would develop zoster within their lifetime.

Epidemiological Features and Costs of Herpes Zoster in Taiwan: a National Study 2000 to 2006

To analyse the epidemiological characteristics and related costs of herpes zoster in Taiwan, a nationally representative cohort of 1,000,000 individuals from the National Health Insurance register was followed up from 2000 to 2006 and their claims data analysed. Overall, 34,280 patients were diagnosed with zoster (incidence 4.89/1000 person-years) and 2944 patients (8.6%) developed post-herpetic neuralgia 3 months after the start of the zoster rash (incidence 0.42/1000 person-years). People with older age, diabetes, and immunocompromising conditions were at higher risk of developing zoster and post-herpetic neuralgia. The overall hospitalization rate for zoster was 16.1 cases per 100,000 person-years. The cost for each home care case and per hospitalized case were approximately 53.30 euro and 1224.70 euro, respectively. Further research into the cost-effectiveness of zoster vaccine is needed.