Epidemiology and long-term disease burden of herpes zoster and postherpetic neuralgia in Taiwan: a population-based, propensity score-matched cohort study

Abstract

BackgroundThe objectives of this study were to characterize the burden of herpes zoster, as well as the longitudinal and incremental changes of healthcare service utilization among individuals with herpes zoster and postherpetic neuralgia (PHN) compared to those without.MethodsUsing the National Health Insurance Research Database (NHIRD), we established a herpes zoster cohort of people diagnosed with herpes zoster between 2004 and 2008 as study cases. Another subset of the NHIRD, which was randomly selected from all elderly beneficiaries between 2004 and 2008 served as a non-herpes-zoster elderly control pool. Each case was then assigned one matched control according to age, gender, index date and propensity score. PHN cases were defined as those with persisting pain for more than 90 days after the onset of herpes zoster.ResultsBetween 2004 and 2008, about 0.6 million patients were newly diagnosed with herpes zoster. The incidence increased with age, and most cases were identified during the summer period. Herpes zoster cases were found to have higher consumption of all types of healthcare services in the first year after the index date. Such increases were particularly obvious for patients with PHN, who showed incremental increases on average of 16.3 outpatient visits, 0.4 emergency room visits and 0.24 inpatient admissions per year.ConclusionsThe incidence of herpes zoster increased with age and changed according to the seasons. Patients with herpes zoster were associated with higher healthcare utilization and this increase in healthcare utilization was most obvious for herpes zoster patients with PHN.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-5247-6) contains supplementary material, which is available to authorized users.

The risk of herpes zoster among patients with ankylosing spondylitis: A population‐based cohort study in Taiwan

“…We found the incidence rate of HZ was 5.54 per 1000 personyears in Taiwan non-AS patients, and 6.52 per 1000 personyears in Taiwan AS patients, in this large population-based study. It was reported that the HZ incidence in Taiwan was 4.04 to 6.24 per 1000 person-years, [11][12][13] which was higher than that in the USA (3.2-3.7 per 1000 person-years) 14 or Europe (3.7 per 1000 personyears). 15 The reason for regional differences in HZ morbidity are still unclear; this may be because of the ethnic distinction and the cultural differences.…”

“…It was reported that the HZ incidence in Taiwan was 4.04 to 6.24 per 1000 person‐years, which was higher than that in the USA (3.2‐3.7 per 1000 person‐years) or Europe (3.7 per 1000 person‐years) . The reason for regional differences in HZ morbidity are still unclear; this may be because of the ethnic distinction and the cultural differences .…”

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

“…These studies spanned the years 2000 to 2011 and differed in their objectives, study years, and methodology. The incidence of HZ in the general population between 2000 and 2008 ranged from 4.45 to 6.89 per 1000 person-years and increased over time [12][13][14][15][16]. HZ was more frequent in women than men (5.09 versus 4.71 per 1000 person-years, 5.20 versus 4.72 per 1000 population) [14,17].…”

“…Seven studies reported HZ incidence in Taiwan and all used the NHIRD [12][13][14][15][16][17][18]. These studies spanned the years 2000 to 2011 and differed in their objectives, study years, and methodology.…”

Postherpetic neuralgia and recalcitrant cystic lesions following herpes zoster: A case report and review of treatment options

“…It is defined as a pain involving a dermatome that is sustained for more than 90 days after acute herpes zoster. 15 Lu et al 16…”