https://orcid.org/0000-0002-0382-0333
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ABSTRACT
We conducted a systematic review to characterize the incidence rate of herpes zoster (HZ) in the general population, specifically in individuals ≥50 years of age. A total of 69 publications were included in the review. We found a cumulative incidence of HZ ranging from 2.9–19.5 cases per 1,000 population and an incidence rate of HZ ranging from 5.23–10.9 cases per 1,000 person-years. The cumulative incidence (3.22–11.2 versus 2.44–8.0 cases per 1,000 population) and incidence rates (6.05–12.8 versus 4.30–8.5 cases per 1,000 person-years) were higher in females than males. Studies revealed a trend of increasing incidence of HZ with increasing age and over time. Variations in incidence estimates can be attributed to the various study designs, case ascertainments, age distributions of the population and year of the study. HZ is associated with a substantial disease burden and is expected to increase due to population aging.
Plain language summary
What is the context?
Herpes Zoster (HZ) occurs due to the reactivation of the varicella zoster virus and is common among adults ≥50 years of age (YOA) as cell-mediated immunity declines due to aging.
Age is a significant risk-factor related to HZ and an increase in life expectancy of the general population may considerably increase the number of HZ cases.
In the context of the world’s aging population, the occurrence of HZ is expected to place an additional burden on patients ≥50 YOA who might already have other health problems to cope with in their everyday life.
What is new?
This systematic review of 69 full-text publications demonstrates that the worldwide incidence of HZ is high among individuals ≥50 YOA with little variation in the different regions of the world.
When comparing the geographical regions, the highest incidences were mostly reported in the Asia-Pacific countries.
Our results suggest that the incidence of HZ is higher in females than in males.
The majority of studies also reported a higher incidence of HZ with increasing age.
Incidence rates did not seem to differ when different case definitions were used.
By ethnicity, incidence rates were the highest among Caucasians and the lowest among Black, Hispanic or other ethnicities.
Studies which reported HZ incidence by year mostly showed an increase in incidence over time.
What is the impact?
This review provides a comprehensive overview of HZ disease burden, that could be considered during the planning and implementation of preventive measures such as vaccination against HZ.
Health care systems around the world are increasingly focusing on promoting healthy aging to prevent diseases and chronic conditions. In this context, the prevention of HZ among the ≥50 YOA population could bring about a reduction in the risks to their health and improve their quality of life.
Acknowledgments
The authors would like to thank Business & Decision Life Sciences platform for editorial assistance and manuscript coordination, on behalf of GSK. Maxime Bessières coordinated manuscript development and editorial support. Amrita Ostawal (Arete Communication UG) provided writing support for this literature review.
Contributorship
All authors were involved in the design of the study. EB, DC, DVO, and HV collected or generated the data. All authors analyzed and/or interpreted the data and participated to the development of this manuscript and in its critical review with important intellectual contributions. All authors had full access to the data and gave approval of the final manuscript before submission. All authors agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The work described was carried out in accordance with ICMJE recommendations for conduct, reporting, editing and publications publishing of scholarly work in medical journals. The corresponding author had the final responsibility to submit for publication.
Conflicts of interest
DVO, DC and JDD are employed by the GSK group of companies. DC and DVO hold shares in the GSK group of companies. BY reports personal fees from the GSK group of companies during the conduct of the study and personal fees from the GSK group of companies outside the submitted work. HV and EB report grants from the GSK group of companies during the conduct of the study and grants from the GSK group of companies and Sanofi Pasteur outside the submitted work.
Disclosures
Trademark
Shingrix is a trademark owned by or licensed to the GSK group of companies.
Zostavax is a trademark owned by or licensed to Merck Sharp & Dohme Corp.
Supplementary material
Supplemental data for this article can be accessed on the publisher’s website.