Prevalence of and factors associated with herpes zoster in England: a cross-sectional analysis of the Health Survey for England

Abstract

Background Herpes zoster (commonly called shingles) is caused by the reactivation of varicella zoster virus, and results in substantial morbidity. While the risk of zoster increases significantly with age and immunosuppression, relatively little is known about other risk factors for zoster. Moreover, much evidence to date stems from electronic healthcare or administrative data. Hence, the aim of this study was to explore potential risk factors for herpes zoster using survey data from a nationally-representative sample of the general community-dwelling population in England. Methods Data were extracted from the 2015 Health Survey for England, an annual cross-sectional representative survey of households in England. The lifetime prevalence of self-reported herpes zoster was described by age, gender and other socio-demographic factors, health behaviours (physical activity levels, body mass index, smoking status and alcohol consumption) and clinical conditions, including; diabetes, respiratory, digestive and genito-urinary system and mental health disorders. Logistic regression models were then used to identify possible factors associated with shingles, and results were presented as odds ratios with 95% confidence intervals. Results The lifetime prevalence of shingles among the sample was 11.5% (12.6% among women, 10.3% among men), which increased with age. After adjusting for a range of covariates, increased age, female gender (odds ratio: 1.21; 95%CI: 1.03, 1.43), White ethnic backgrounds (odds ratio: 2.00; 95%CI: 1.40, 2.88), moderate physical activity 7 days per week (odds ratio: 1.29; 95%CI: 1.01, 1.66) and digestive disorders (odds ratio: 1.51; 95%CI: 1.13, 1.51) were each associated with increased odds of having had herpes zoster. Conclusions Age, gender, ethnicity and digestive disorders may be risk factors for herpes zoster among a nationally representative sample of adults in England. These potential risk factors and possible mechanisms should be further explored using longitudinal studies.

Pharmacological Treatment of Herpes Zoster and Factors Associated with Its Recurrence

“…The patients with herpes zoster in the present study had a mean age similar to that reported in other studies (54.9–57.1 years) [ 20 , 23 , 24 ], and there was a predominance in women, as found in other studies (55.5%–64.5%) [ 3 , 9 , 14 , 15 , 20 , 25 ]. Women were found to have a higher risk of presenting a first recurrence of herpes zoster, consistent with other reports [ 17 , 18 , 25 ]. Likewise, increasing age was a risk factor, consistent with other studies [ 17 , 18 , 25 ].…”

Association of asthma and herpes zoster, the role of vaccination: A literature review

“…3 Herpes zoster (HZ) is considered to be reactivated by a previous infection with VZV and nearly has the same transmission routes either by direct contact or by infected respiratory secretion. In a review by Thomas et al, 4 stated that the lifetime prevalence of HZ was 10%-30% and may rise to 50% in those over 85 years old; another cross-sectional study performed in England stated that the lifetime prevalence among English population was 12.6% for female and 10.3% for males 5 and the risk increased among those of white ethnicity and ex-smokers. 5 HZ is mainly presented by erythematous skin rash, which is very painful; this maculopapular rash is confined to one area of the skin called the dermatome and is usually present on one side of the body.…”

“…In a review by Thomas et al, 4 stated that the lifetime prevalence of HZ was 10%-30% and may rise to 50% in those over 85 years old; another cross-sectional study performed in England stated that the lifetime prevalence among English population was 12.6% for female and 10.3% for males 5 and the risk increased among those of white ethnicity and ex-smokers. 5 HZ is mainly presented by erythematous skin rash, which is very painful; this maculopapular rash is confined to one area of the skin called the dermatome and is usually present on one side of the body. 6 Some people reported a burning sensation in the dermatome before the appearance of the rash; they describe it as an electric sensation.…”

“…Although the exact cause of HZ reactivation is still unknown, many risk factors are thought to play a role in this reactivation; some of which are related to stress and family history, others are related to any condition causing immunosuppression or decrease in cellular immunity, such as malignancy, steroid, and aging which was explicitly found to double the risk of the disease after the age of 50 4,9,10 and in another recent systematic review, the pooled analysis showed a higher risk of HZ in older age in comparison to young age (risk ratio [RR] = 1.65, 95% confidence interval [CI] = 1.37–1.97) 11 . In addition, several chronic debilitating diseases like diabetes mellitus, cardiovascular diseases, bronchial asthma, and chronic obstructive pulmonary disease were also found to be potential risk factors for HZ 5,12 …”

“…11 In addition, several chronic debilitating diseases like diabetes mellitus, cardiovascular diseases, bronchial asthma, and chronic obstructive pulmonary disease were also found to be potential risk factors for HZ. 5,12 However, there have not been many detailed studies to entail an association between herpes and asthma. To our knowledge, this is the first and to date evidence of literature review providing insights regarding herpes and its association with asthma.…”