A systematic literature review to assess the burden of herpes zoster disease in China

Abstract

Introduction: Herpes zoster (HZ) or shingles occurs as a result of reactivation after a primary infection with varicella zoster virus (chickenpox). The burden of HZ in older adults in China is not well understood. We conducted a systematic literature review to understand the burden of disease related to HZ, its complications, and associated costs in China. Areas covered: Using publications retrieved from Chinese and English literature databases, we described incidence and prevalence of HZ, occurrence of HZ-related complications, and costs associated with HZ in mainland China, Taiwan, and Hong Kong. Expert opinion: The data, although limited, indicate that the burden of disease due to HZ is substantial in China, with incidence rates that are comparable to the rest of the world. Recently, an adjuvanted recombinant HZ vaccine was approved for use in China. Disease prevention is likely to reduce the burden of disease, with potentially significant economic benefits. However, understanding the public health impact of vaccination in China will require extensive baseline information about incidence, complication rates, and associated costs. This review gives an overview of available research, but also reveals existing gaps. Well-designed observational studies are needed to quantify the total burden of disease and potential impact of prevention through vaccination.

Potential public health impact of the adjuvanted recombinant zoster vaccine among people aged 50 years and older in Beijing

“…6,13 This is a particular concern in view of China's aging population, where the proportion of adults ≥50 YOA is increasing by 3-4% annually. 13 At least 2.8 million new cases may be expected annually across China, with a predicted 55,000 cases a year in Beijing city alone. 14 Current treatment options remain limited; antivirals must be administered within 72 hours of symptom onset in order to be effective.…”

“…4,5 While traditional medicines may also be frequently used for the management of HZ in China, their effectiveness and role in HZ treatment and protection against the development of complications are not well-understood. 13 The National Medical Products Administration approved the adjuvanted recombinant zoster vaccine (RZV, Shingrix, GSK) in China in May 2019, for use in adults ≥50 YOA to prevent HZ. 16 This non-live vaccine combines VZV glycoprotein E with the proprietary adjuvant system AS01 B , which boosts immunogenicity and duration of the immune response.…”

“…11 , 12 A systematic literature review focusing on China reported an HZ incidence ranging between 2.9–5.8 per 1,000 person-years among adults ≥50 years of age (YOA), suggesting a substantial burden of HZ in China comparable to the rest of the world. 6 , 13 This is a particular concern in view of China’s aging population, where the proportion of adults ≥50 YOA is increasing by 3–4% annually. 13 At least 2.8 million new cases may be expected annually across China, with a predicted 55,000 cases a year in Beijing city alone.…”

“… 6 , 13 This is a particular concern in view of China’s aging population, where the proportion of adults ≥50 YOA is increasing by 3–4% annually. 13 At least 2.8 million new cases may be expected annually across China, with a predicted 55,000 cases a year in Beijing city alone. 14 …”

“… 4 , 5 While traditional medicines may also be frequently used for the management of HZ in China, their effectiveness and role in HZ treatment and protection against the development of complications are not well-understood. 13 …”