Global herpes zoster incidence, burden of disease, and vaccine availability: a narrative review

Abstract

Herpes zoster (HZ) is a neurocutaneous disease that causes significant morbidity worldwide. The disease is caused by the reactivation of the varicella-zoster virus (VZV), which leads to the development of a painful, vesicular rash and can cause complications such as post-herpetic neuralgia and vision loss. Globally, the incidence of HZ is increasing, and it incurs billions in cost annually to the healthcare system and to society through loss of productivity. With the advent of effective vaccines such as the live attenuated vaccine, Zostavax®, in 2006, and more recently the adjuvant recombinant subunit vaccine, Shingrix®, in 2017, HZ has become a preventable disease. However, access to the vaccines remains mostly limited to countries with developed economies, such as the United States and Canada. Even among countries with developed economies that license the vaccine, few have implemented HZ vaccination into their national immunization schedules due to cost-effectiveness considerations. In this review, we discuss the currently available HZ vaccines, landscape of HZ vaccine guidelines, and economic burden of disease in countries with developed and developing economies, as well as barriers and considerations in HZ vaccine access on a global scale.

Vaccination against Varicella Zoster Virus in the Spanish ophthalmological community survey. Is it time for a paradigm shift?

“…Regarding the economic analysis of vaccination, although there is signi cant heterogeneity, most studies determined that HZ vaccination was cost-effective when given at ages over 65 or 70 (33). In a study speci cally conducted in Spain, it was shown that the most cost-effective strategy in the general population was vaccination of the 65-year-old cohort and older with the recombinant vaccine (Shingrix) (34).…”

Comparing Prodrugs with Acyclovir for Treating Postherpetic Neuralgia among Herpes Zoster Patients: A Systematic Review and Meta-Analysis

“…Additionally, the FV-100 is a prodrug for the bicyclic nucleoside analog CF-1743 [ 43 ]. Previous RCT also indicated that FV-100 for the treatment of HZ could reduce the pain associated with HZ and the incidence of PHN [ 44 ]. Those drugs are very new, more research is needed to validate overall efficacy.…”

A Case of Orbital Apex Syndrome Related to Herpes Zoster Ophtalmicus

“…Herpes zoster results from reactivation of the varicella zoster virus (VZV) and has been increasing in recent years [ 1 ]. Reactivation occurs more than decades after the initial infection.…”

“…Reactivation occurs more than decades after the initial infection. Suppressed immune responses due to such as aging and diabetes are considered to be the reason for reactivation of VZV [ 1 ]. Although it is found in various parts of the body with painful cutaneous vesicules, if it is found on the face, especially around the eyes, it is treated as herpes zoster ophthalmicus (HZO).…”