A systematic literature review of the epidemiology and burden of herpes zoster in selected locales in Asia Pacific

Figures & data

Figure 1. PRISMA flowchart detailing the number of records identified from searches and included in this manuscript. The number of records identified through database searches are combined for the systematic literature review and targeted literature review. HZ: herpes zoster; HCRU: healthcare resource utilization; PRISMA: preferred reporting items for systematic reviews and meta-Analyses; SLR: systematic literature review; TLR: targeted literature review.

Figure 2. Trends across age groups for (a) HZ incidence overall and (b) HZ incidence by sex across selected locales in Asia-Pacific. Open circles represent data for the specified age group and above (i.e., ≥70, ≥80 years). Only data points with values > 0.1 have been included. (a) For studies that reported HZ incidence for multiple periods, data for each period are represented by individual lines, with the period indicated after the study name. (b) Data are presented collectively for all locales included in the SLR and differentiated only by male and female to focus on overall potential sex-specific trends^.aFirst data point was for age group 18–30 years; ^bFinal data point for 70–79 years was from year 2007. HZ: herpes zoster; PY: person-years. Articles included: Australia,^21–23 China,²⁴ Japan,^25–29 Korea,^30–32 and Taiwan.³³

Figure 3. Trends over time for (a) HZ incidence overall, (b) HZ incidence by sex, and (c) all HZ-related hospitalization rates across selected locales in Asia-Pacific. Only data for the overall population (all ages) have been included. Filled circles and solid lines represent data specific to the respective year and trend, respectively; open circles and dashed lines represent an average value over the period specified. (c) Hospitalization rates included all patients with HZ-related diagnosis (principal or non-principal), unless otherwise stated. ^aHospitalization for principal HZ diagnosis only; ^bStudy investigated HZ hospitalization rates in periods based on the availability and funding status of varicella vaccination in Australia; ^cStudy did not specify if hospitalization data included patients with principal and/or non-principal HZ diagnosis; ^dHospitalization for nonindigenous Australians up to age 70 years only. HZ: herpes zoster; PY: person-years. Articles included: Australia,^34–38 China,²⁴ Japan,^{25,28,29,39,40} Korea,^{30,31,41–44} New Zealand,⁴⁵ and Taiwan.^33,46–48

Table 1A. HZ incidence and recurrence rates across selected locales in Asia-Pacific (study-specific findings).

Locale	Study design	Incidence in adults aged ≥50 years per 1,000 PY [age; period]	Incidence in overall population per 1,000 PY [all ages unless specified; period]	HZ recurrence per 1,000 PY or otherwise specified [age; period]
Australia	Prospective cohort	Liu 2015^Citation21 12.1 [>80; 2006–09] Qian 2021^Citation50 9.4^a [≥45; 2004–15]	NR	Qian 2021^Citation50 11.1 [≥45; 2004–15]
	Retrospective cohort	Lin 2021^Citation23 7.5 [70–79; 2017] 5.3 [70–79; 2018] Lin 2022^b,Citation22 7.7 [60–69; 2013–16] 8.3 [60–69; 2016–18] 9.5 [70–79; 2013–16] 7.5 [70–79; 2016–18] 9.0 [80–89; 2013–16] 9.3 [80–89; 2016–18]	NR	NR
China	Cross-sectional survey	Zhu 2015^Citation59 4.3 [≥50; 2011–13] 4.1 [≥50; 2011] 3.4 [≥50; 2012] 5.8 [≥50; 2013]	NR	NR
	Retrospective cohort	Sun 2021^Citation54 6.6 [≥50; 2015–17] 6.1 [≥50; 2015] 6.5 [≥50; 2016] 7.4 [≥50; 2017] 5.1 [50–54; 2015–17] 7.0 [55–59; 2015–17] 7.7 [60–64; 2015–17] 8.4 [65–69; 2015–17] 8.6 [70–74; 2015–17] 7.8 [75–79; 2015–17] 5.7 [80–84; 2015–17] 2.1 [≥85; 2015–17] Li 2022^Citation24 0.5 [50–59; 2013] 0.6 [50–59; 2014] 1.1 [50–59; 2015] 1.5 [50–59; 2016] 1.7 [50–59; 2017] 0.7 [60–69; 2013] 0.9 [60–69; 2014] 1.7 [60–69; 2015] 2.1 [60–69; 2016] 2.5 [60–69; 2017] 1.1 [≥70; 2013] 1.4 [≥70; 2014] 2.4 [≥70; 2015] 3.2 [≥70; 2016] 3.2 [≥70; 2017]	Li 2022^Citation24 0.3 [2013] 0.4 [2014] 0.7 [2015] 1.0 [2016] 1.2 [2017]	Li 2016^Citation53 2.8%^c [≥50; 2010–12] Sun 2021^Citation54 16.6 [≥50; 2015–17] 13.8 [50–54; 2015–17] 9.4 [55–59; 2015–17] 13.1 [60–64; 2015–17] 20.9 [65–69; 2015–17] 24.6 [70–74; 2015–17] 28.1 [75–79; 2015–17] 36.7 [80–84; 2015–17] 20.9 [≥85; 2015–17]
	Retrospective survey	NR	NR	Lu 2018^Citation52 11.1%^d [>0; 2012–13]
Japan	Ecological study	Toyama 2018^Citation39 6.2 [>60; 1997] 9.5 [>60; 2017]	Toyama 2018^Citation39 3.6 [1997] 6.0 [2017]	NR
	Prospective cohort	Toyama 2009^Citation29 5.2 [50–59; 1997–2006] 7.0 [60–69; 1997–2006] 7.8 [70–79; 1997–2006] 6.9 [80–89; 1997–2006] 5.4 [≥90; 1997–2006] Takao 2015^Citation27 10.9 [≥50; 2008–12] 9.2 [50–59; 2008–12] 9.6 [60–69; 2008–12] 12.9 [70–79; 2008–12] 12.6 [≥80; 2008–12] Nakamura 2016^Citation58 11.0 [≥50; 2008–11] Sato 2017^Citation26 10.2 [≥60; 2013–15] 9.2 [60–69; 2013–15] 10.4 [70–79; 2013–15] 12.1 [≥80; 2013–15] Yamada 2019^Citation81 5.6 [≥50; 2009–12] Kawahira 2022^Citation120 9.3/12.2/8.2^e [≥50; 2008–09]	Toyama 2009^Citation29 4.2 [1997–2006]	Nakamura 2016^Citation58 10.1 [≥50; 2008–11]
	Retrospective cohort	Shiraki 2017^Citation25 8.7 [70–80; 2009–15] Shiraki 2021^Citation28 5.2 [50–59; 1997] 5.2 [50–59; 2014] 6.7 [50–59; 2020] 6.2 [60–69; 1997] 7.8 [60–69; 2014] 8.8 [60–69; 2020] 6.5 [70–79; 1997] 9.5 [70–79; 2014] 10.5 [70–79; 2020] 5.7 [80–89; 1997] 8.6 [80–89; 2014] 10.0 [80–89; 2020] 4.7 [≥90; 1997] 6.4 [≥90; 2014] 7.6 [≥90; 2020]	Shiraki 2017^Citation25 4.8 [2009–15] Imafuku 2019^Citation70 4.9 [≥18 YOA; 2005–14] Kobayashi 2019^Citation121 1.5 [2005–16] Shiraki 2021^Citation28 3.6 [1997] 5.2 [2014] 6.5 [2020]	Shiraki 2017^Citation25 0.3 [>0; 2009–15]
Korea	Cross-sectional survey	NR	NR	Ha 2017^Citation122 1.2%^c [>0; 2005–15]
	Prospective cohort	Kwon 2016^Citation31 16.7 [50–60; 2003–13] 17.8 [60–70; 2003–13] 14.2 [>70; 2003–13]	Kwon 2016^Citation31 9.9 [≥18 YOA; 2003–13]
	Retrospective cohort	Kim 2014^Citation30 17.4 [50–59; 2011] 22.4 [60–69; 2011] 21.8 [70–79; 2011] 16.5 [≥80; 2011] Bae 2020^Citation32 16.7 [≥50; 2002–13] 16.1 [50–59; 2002–13] 18.2 [60–69; 2002–13] 15.4 [≥70; 2002–13] Cho 2020^Citation123 10.7–14.5^a [40–79; 2004–13]	Kim 2014^Citation30 10.4 [2011] Choi 2019^Citation41 4.2 [2006] 9.2 [2015] Choi 2019^Citation42 2.7 [2003] 3.0 [2004] 3.5 [2005] 4.0 [2006] 5.5 [2007] 6.8 [2008] 7.3 [2009] 7.7 [2010] 8.3 [2011] 9.0 [2012] 9.5 [2013] 9.7 [2014] 9.8 [2015] Kim 2019^Citation43 5.1 [>20 YOA; 2002–13]	Kim 2019^Citation43 12.0 [>20; 2002–13] 5.3%^c [>20; 2002–13] 4.5%^c [20–50; 2002–13] 5.8%^c [>50; 2002–13]
Taiwan	Ecological study	NR	Wu 2013^Citation48 4.0 [2000] 6.2 [2009]	NR
	Retrospective cohort	Chao 2012^Citation33 8.1 [50–59; 2000] 12.1 [50–59; 2008] 10.5 [60–69; 2000] 14.9 [60–69; 2008] 12.5 [70–79; 2000] 17.2 [70–79; 2007] Lu 2018^Citation46 9.2 [50–64; 2004] 9.5 [50–64; 2005] 9.6 [50–64; 2006] 9.7 [50–64; 2007] 10.0 [50–64; 2008] 12.3 [65–74; 2004] 12.1 [65–74; 2005] 12.1 [65–74; 2006] 12.5 [65–74; 2007] 12.8 [65–74; 2008]	Jih 2009^Citation47 4.9 [2000–06] Chao 2012^Citation33 4.5 [2000] 4.6 [2001] 5.4 [2002] 5.3 [2003] 6.0 [2004] 6.2 [2005] 6.5 [2006] 6.6 [2007] 6.9 [2008] Lu 2018^Citation46 5.0 [2004] 5.3 [2005] 5.3 [2006] 5.4 [2007] 5.7 [2008]	NR
		12.6 [75–84; 2004] 12.6 [75–84; 2005] 13.0 [75–84; 2006] 13.1 [75–84; 2007]
		13.5 [75–84; 2008] 11.2 [≥85; 2004] 11.4 [≥85; 2005] 11.0 [≥85; 2006] 11.8 [≥85; 2007] 12.4 [≥85; 2008]

^aData were only available for the age group presented which mostly consists of and may reasonably represent the data of adults aged ≥50 years; ^bData reported for before (Nov 2013–Oct 2016) and after (Nov 2016–Oct 2018) national HZ immunization program; ^cProportion of incident HZ cases with recurrence; ^dProportion of interviewed HZ patients with recurrent HZ; ^eIncidence according to BMI status under/normal/overweight. BMI: body mass index; HZ: herpes zoster; PY: person-years; NR: not reported; YOA: years of age.

Table 1B. HZ-related hospitalization rates across selected locales in Asia-Pacific (study-specific findings).

Locale	Study design	Hospitalization in adults aged ≥50 years per 100,000 or otherwise specified [age; period]	Hospitalization in overall population per 100,000 or otherwise specified [all ages unless specified; period]
Australia	Ecological study	Heywood 2014^Citation37 17.6 [50–59; 1998–99] 17.0 [50–59; 2000–03] 18.3 [50–59; 2004–05] 16.4 [50–59; 2006–10] 46.3 [60–69; 1998–99] 38.7 [60–69; 2000–03] 42.3 [60–69; 2004–05] 42.4 [60–69; 2006–10] 129.3 [70–79; 1998–99] 120.2 [70–79; 2000–03] 116.5 [70–79; 2004–05] 105.9 [70–79; 2006–10] 296.1 [≥80; 1998–99] 271.0 [≥80; 2000–03] 280.4 [≥80; 2004–05] 271.5 [≥80; 2006–10]	Heywood 2014^Citation37 24.8 [1998–99] 23.9 [2000–03] 25.2 [2004–05] 24.5 [2006–10]
	Prospective cohort	Liu 2015^Citation21 0.9/1,000 PY [>80; 2006–11]	NR
	Retrospective cohort	Stein 2009^Citation51 67 [≥50; 1998–2005]	NR
	Retrospective review	Carville 2010^Citation36 10.0 [50–59; 1995–99] 12.1 [50–59; 2000–05] 12.3 [50–59; 2006–07] 25.2 [60–69; 1995–99] 30.3 [60–69; 2000–05] 35.4 [60–69; 2006–07] 63.3 [70–79; 1995–99] 89.9 [70–79; 2000–05] 91.1 [70–79; 2006–07] 148.4 [≥80; 1995–99] 187.8 [≥80; 2000–05] 214.2 [≥80; 2006–07] MacIntyre 2015^Citation34 19 [50–59; 1998–2005] 18 [50–59; 2007–12] 41 [60–69; 1998–2005] 43 [60–69; 2007–12] 123 [70–79; 1998–2005] 112 [70–79; 2007–12] 267.3 [>80; 1998–2005] 289.1 [>80; 2007–12] Sheel 2017^a,Citation38 8.3 [50–59; 2007–11] 18.8 [60–69; 2007–11] 44.8 [70–79; 2007–11] 89.8 [≥80; 2007–11] Sheel 2018^Citation35 17.9 [50–59; 1999–2013] 43.2 [60–69; 1999–2013] 90.2 [70–74; 1999–2013] 228.1 [≥75; 1999–2013]	Carville 2010^Citation36 13.4 [1995–99] 18.2 [2000–05] 20.5 [2006–07] MacIntyre 2015^Citation34 24.6 [1998–2005] 26.7 [2007–12] Sheel 2017^a,b,Citation38 11.2 [2007–11] Sheel 2018^Citation35 25.9 [1999–2013]
Hong Kong	Retrospective review	Chan 2018^Citation68 117 [≥60; 2004–15]	NR
	Self-controlled case series	NR	Wan 2022^Citation124 7.9 per 1 million BNT162b2 doses administered^c [≥16 YOA; 2021] 7.1 per 1 million CoronaVac doses administered^c [≥18 YOA; 2021]
Japan	Cross-sectional survey	Kuniyoshi 2021^d,Citation40 35.3 [61–79; 2013–18] 63.2 [≥80; 2013–18]	Kuniyoshi 2021^d,62 17.1 [2013] 17.5 [2014] 18.4 [2015] 18.2 [2016] 18.3 [2017] 18.4 [2018]
Korea	Retrospective cohort	Cho 2020^Citation123 0.6–1.2 per 1,000 PY [40–79^e; 2004–13]	Choi 2010^a,Citation44 22 [2003] 25 [2004] 27 [2005] 30 [2006] 32 [2007]
Taiwan	Retrospective cohort	NR	Jih 2009^a,Citation47 16.1/100,000 PY [2000–06]

Table presents data for all HZ-related hospitalizations (principal and non-principal HZ diagnoses), unless otherwise stated. ^aHospitalization for principal HZ diagnosis only; ^bHospitalization for non-indigenous Australians up to age 70 years only; ^cHospitalization with principal diagnosis of HZ within 28 days of vaccination; ^dStudy did not specify if hospitalization data included patients with principal and/or non-principal HZ diagnosis; ^eData were only available for the age group presented which mostly consists of and may reasonably represent the data of adults aged ≥50 years. HZ: herpes zoster; PY: person-years; NR: not reported.

Figure 4. Proportion of HZ cases with HZ-related complications across selected locales in Asia-Pacific. Black bars represent data of all HZ patients in the study population; blue bars represent data of a study population comprising hospitalized HZ patients only; orange bars represent data of a study population comprising HZO patients only. ^aPatients with pain persisting for at least 3 months from HZ onset; ^bStudy did not specify the duration of pain in patients diagnosed with PHN; ^cPHN was defined as pain persisting for at least 90 days after HZ rash healed; ^dPatients with persistent pain at 6 months from HZ onset; ^eData pooled from patients in Taiwan, Korea, and Thailand; ^fOther complications include motor dysfunction (Tang 2022) or were otherwise not defined. HZ: herpes zoster; HZO: herpes zoster ophthalmicus; PHN: postherpetic neuralgia. Articles included: dermatological/soft tissue infection,^26,49,69 disseminated HZ,^{51,54,68,70,71} ear-related/Ramsay-hunt syndrome,^54,68,71 encephalitis,^51,54,68 lower respiratory tract infection,⁴⁹ meningitis,^51,68,72,73 meningitis encephalitis,⁷¹ neurological,^{26, 51,68–70,72} ocular/ophthalmic,^{26,49,51,54,55,68–72 ,74–76} PHN,^{26,27,35,46,47,52–54,59,68–71,75,77–89} vision loss,^90,91 and other.^{26,51,54,70,72,92}.

Table 2. HZ-related healthcare resource utilization in patients with HZ across selected locales in Asia-Pacific (mean per HZ case across period of available data, unless otherwise stated).

Locale	Source	Study period	Age (years)	Patient disease profile	GP visits (n/case)	Outpatient visits (n/case)	Hospitalizations^a (n/case or % cases)	LOS (mean days)	ED visits (n/case or % cases)
Australia	Stein 2009^Citation51	2000–2006^b	≥50	All cases	1.9–3.0	NR	• Principal HZ: 28/10^5 cases • Non-principal HZ: 39/10^5 cases	6.8 (principal HZ)	38.2/10^5 cases
Australia	Liu 2015^Citation21	2006–2009	≥45	All cases	NR	NR	3.3%	NR	NR
Australia	Karki 2016^Citation98	2006–2009 (recruitment) to 2011^b	≥45	All cases^c	1.6 (excess)	2.0 (excess prescriptions filled)	0.06 (excess)	NR	0.11 (excess)
Australia	Qian 2021^Citation50	2004–2015	≥45	All cases	NR	NR	• First HZ episode: 2.5% • Recurrent HZ: 2.7%	NR	NR
China	Zhu 2015^Citation59	2011–2013	≥50	All cases	NR	NR	6.9%^d	NR	NR
China	Li 2016^Citation53	2013–2014	≥50	All cases	NR	NR	4.5%^d	10	NR
China	Lu 2018^Citation52	2012–2013	All ages	All cases	NR	NR	2.3%^d	NR	NR
				Non-PHN	NR	NR	1.9%^d	NR	NR
				PHN	NR	NR	10%^d	NR	NR
China	Yu 2019^Citation99	2016^b	≥40	All cases	NR	9.4	0.7	14.9	0.4
				PHN-related	NR	5.8	0.4	9.2	0.4
China	Sun 2021^Citation54	2015–2017	≥50	w/complications	NR	5.6	2.0	22.5	NR
				w/o complications	NR	3.3	2.3	20.8	NR
Hong Kong	Ming 2019^Citation71	2011–2013	≥50	All cases	NR	NR	NR	7.1^d	NR
Japan	Nakamura 2017^Citation69	2013–2015	≥60	All cases	NR	5.7	1.9%^d	9.4	NR
Japan	Sato 2017^Citation26	2013–2015	≥60	All cases	NR	5.7	3.4%^d,e	NR	NR
Japan	Imafuku 2019^Citation70	2005–2014	≥18	All cases	NR	3.4	2.3%^d	9.1	NR
Japan	Hashizume 2022^Citation100	2012–2018	≥40	All cases	NR	NR	7.1%^d	NR	NR
Japan	Ishikawa 2022^Citation74	2016–2018	All ages	Hospitalized HZ	NR	NR	N/A	Median: 9	NR
Korea	Cheong 2014^Citation101	2009^b	≥50	All cases	NR	4.0	4.8%^e,f	10.9	0.9%^g
Korea	Choi 2014^Citation102	2007–2010	All ages	Immunocompetent	NR	Median: 3.0	36.6%^e,f	Median: 7.8	NR
Korea	Kim 2014^Citation30	2011	All ages	All cases	NR	NR	• All ages: 0.05 • ≥50 YOA: 6.2%	NR	NR
Korea	Song 2014^Citation103	2009–2010	≥50	All cases	7.0	5.0	32.5%^d (over 180 days)	8.9	1.3
Korea	Hong 2016^Citation94	2009–2013	All ages	PHN^h	NR	1.0	• Hospital visits: 4.7 • General hospital visits: 3.8	NR	NR
Korea	Kim 2019^Citation43	2002–2013	≥20	All cases	NR	NR	7.7%^d	NR	NR
Taiwan	Jih 2009^Citation47	2000–2006	All ages	All cases	NR	NR	NR	8.3^f	NR
Taiwan	Lin 2010^Citation49	2000–2005	All ages	All cases	NR	NR	2.9%^f	8.3	NR
Taiwan	Tsai 2015^Citation83	2008–2009	≥50	All cases	6.0	2.8	20.7%^d (over 180 days)	NR	1.3
Taiwan	Lu 2018^Citation46	2004–2008	All ages	All cases	NR	25.6	0.24^f	NR	0.42
				Non-PHN	NR	25.5	0.24^f	NR	0.42
				PHN	NR	30.4	0.28^f	NR	0.54

^aData are presented for all HZ-related hospitalizations (principal and non-principal HZ diagnoses), unless otherwise stated. Data for the proportion of HZ cases hospitalized are within the study population over the study period; ^bAnnualized data presented; ^cExcess HCRU compared with matched control; ^dStudy did not specify if hospitalization data included patients with principal and/or non-principal HZ diagnosis; ^eProportion of patients with HZ within the study area, not necessarily enrolled in the prospective part of the study; ^fHospitalization for principal HZ diagnosis only; ^gPercentage of those with any history of an emergency department visit among all HZ patients; ^hPatients with primary or secondary PHN diagnoses. ED: emergency department; GP: general practitioner; HCRU: healthcare resource utilization; HZ: herpes zoster; LOS: length of stay; N/A: not applicable; NR: not reported; PHN: postherpetic neuralgia; w/: with; w/o: without; YOA: years of age.

Table 3. HZ-related adjusted-direct and indirect costs, and cost components across selected locales in Asia-Pacific.

					Direct cost
Locale	Source	Study period	Age (years)	Patient disease profile	Total all-cause cost (USD)	Cost components	Indirect cost (USD)
Mean per HZ case
Australia	Stein 2009^Citation51	General practice (2000–2006) and hospitals (1998–2005)	≥50	All cases	832.78–870.00	Healthcare resource (GP visits, outpatient visits, and ED visits, hospitalization)	NR
China	Li 2016^Citation53	2010–2012 (costs converted into 2013 price)	≥50	All cases	187.51^a	Drugs (OTC), healthcare resource (outpatient visits, hospitalization), others (transport, productivity loss [caring for patient], cost considered to be associated with HZ)	NR
				w/sequelae	272.56^a
				w/o sequelae	118.31^a
China	Yu 2019^Citation99	2016	≥40	w/PHN	Annual: 2,062.89	Drugs (TCM, prescription medicine), therapy (physical therapy, acupuncture, massage, heat therapy, exercise, transcutaneous electrical nerve stimulation, chiropractor, yoga, spinal decompression), healthcare resource (consults, ED visits, hospitalization)	Annual PHN-related productivity loss • Absenteeism: 2,437.36 • Presenteeism: 3,746.05 • Total indirect costs: 5,546.15
Hong Kong	Ming 2019^Citation71	2011–2013	≥50	All hospitalized cases	5,734.85	Drugs (medication), healthcare resource (hospitalization), laboratory tests	NR
Japan	Honda 2017^Citation104	2005–2013	≥18	w/PHN	6-month treatment period: • Up to May 2010: 1,337.56 • From Jun 2010: 1,503.78	Drugs (pregabalin, pain-relief treatment, prescription medicine), healthcare resource (outpatient visits, hospitalization), procedures	NR
Japan	Nakamura 2017^Citation69	2013–2015	≥60	All cases	484.26	Drugs (medications, injections, ointment treatment), healthcare resource (outpatient visits, hospitalization), other procedures	HZ-related productivity loss: 119.86
				w/o complications	394.14		NR
				w/PHN	1,056.55
				w/non-PHN complications	745.74
Japan	Imafuku 2019^Citation70	2005–2014 (costs evaluated for 2012–2014)	≥18	All cases	382.16	Drugs (prescription medications [antivirals, analgesics, dermatological], injections, topical, other HZ-related treatments), healthcare resource (outpatient visits, hospitalization), laboratory tests	NR
				w/o complications	287.50
				w/PHN	1,315.57
				w/non-PHN complications	671.06
Korea	Cheong 2014^Citation101	2009 (costs inflated to 2013 price)	≥50	All cases	• 264.69 (HZ management) • 254.17 (PHN management)	Drugs (antivirals, non-narcotics, anti-epileptics) and amount reimbursed by the NHI to medical providers	NR
				Immunocompetent	• 242.13 (HZ management) • 228.60 (PHN management)
Korea	Choi 2014^Citation102	2007–2010	All ages	Immunocompetent	Median: 582.74	Drugs (medication), healthcare resource (inpatient, outpatient), procedures	NR
Singapore	Chen 2015^Citation75	2010–2013	≥50	All cases	370.89^a	Drugs (antiviral, pain medicine), healthcare resource (consultation, hospitalization)	NR
				w/PHN	392.14		Absenteeism: 60.23
				w/o PHN	203.66		Absenteeism: 87.88
Taiwan	Jih 2009^Citation47	2000–2006	All ages	All cases under home care	133.98	Drugs (NSAIDS, acetaminophen, antivirals, systemic corticosteroid, others [anti-depressants, anti-convulsants, opiates, Chinese herbal medicine, topical NSAID, acupuncture, lidocaine cream]), healthcare resource (outpatient visits, hospitalization)	NR
				All hospitalized cases	3,080.36
Annual socioeconomic cost
Korea	Choi 2010^Citation44	2003–2007	All ages	All cases	• 2003: 191.3 mil • 2004: 221.8 mil • 2005: 244.2 mil • 2006: 262.6 mil • 2007: 276.7 mil	Drugs (medication), healthcare resource (clinic visits, hospitalizations), others (transport, nursing)	HZ-related productivity loss • 2003: 30.4 mil • 2004: 33.1 mil • 2005: 37.6 mil • 2006: 41.7 mil • 2007: 44.8 mil
Taiwan	Lin 2010^Citation49	2000–2005	All ages	All cases	• 2000: 25.8 mil • 2004: 27.5 mil	Medical expenditure related to HZ treatment (unspecified)	NR

Only studies that reported total all-cause direct cost data and corresponding cost components are included. To facilitate comparisons between different locales and to account for inflation, all HZ-related cost estimates were adjusted to 2022 values based on the worldwide inflation rate from the World Bank Database, then converted to United States Dollars (USD) if the cost was reported in another currency, based on 2022 currency conversion rates obtained from the United Nations Conference on Trade and Development (UNCTAD) database. Therefore, numerical values may differ from those reported within the referenced articles. ^aInclusive of direct costs and indirect costs from productivity loss. ED: emergency department; GP: general practitioner; HZ: herpes zoster; NHI: National Health Insurance; NR: not reported; NSAID: nonsteroidal anti-inflammatory drug; OTC: over the counter; PHN: postherpetic neuralgia; TCM: traditional Chinese medicine; UNCTAD: United Nations Conference on Trade and Development; USD: United States Dollar; w/: with; w/o: without.

Table 4. HZ-related quality of life outcomes across selected locales in Asia-Pacific.

Locale (Source)	Setting	QoL outcomes
China (Yu 2019)^Citation99	Hospital-based study, 2016, PHN patients ≥40 years	Patient-reported outcomes collected through EQ-5D-3 L questionnaire. Mean (SD) EQ-5D-3 L scores of 0.65 (0.20) on the calculated health utility index and 60.1 (18.6) on the visual analog scale at the time of survey completion.^a Self-reported pain of moderate severity and mild-to-moderate pain interference, poor HRQoL, short duration and poor quality of sleep.
Japan (Mizukami 2018)^Citation96	Hospital/clinic-based study, 2013–2015, ≥60 years	Patient-reported outcomes collected through EQ-5D and SF-12 questionnaires. Pain score and impaired QoL were almost resolved by Day 90 from the onset of HZ rash (Day 0) only in patients who did not develop PHN, but not in patients with PHN. Mean (SD) EQ-5D score increased from 0.76 (0.14) on Day 0 to 0.95 (0.14) on Day 90 in HZ patients without PHN. Mean (SD) EQ-5D score was comparable at 0.68 (0.14) on Day 0 and 0.75 (0.13) on Day 90 in HZ patients with PHN.
Korea (Song 2014)^Citation103	Hospital-based study, 2009–2010, HZ cases ≥50 years	Patient-reported outcomes collected through EQ-5D questionnaire. Mean (SD) EQ-5D score decreased from 0.91 (0.12) prior to HZ to 0.65 (0.16) after HZ onset. QoL subsequently improved, however EQ-5D score remained significantly lower until 180 days of follow-up, compared with before the onset of HZ.
Taiwan (Tsai 2015)^Citation83	Hospital/clinic-based study, 2008–2009, ≥50 years	Patient-reported outcomes collected through EQ-5D questionnaire. Mean (SD) EQ-5D score significantly decreased from 0.91 (0.16) before rash onset to 0.67 (0.18) after rash onset at study enrollment, showing significant QoL deterioration up to 60 days. Mean (SD) EQ-5D increased slightly from 0.67 (0.18) after rash onset at study enrollment to 0.85 (0.18) at 30 days of follow-up. Impact of HZ on QoL and pain severity was similar across age groups.

^aPatients identified with PHN during a specialist office visit were recruited to complete the questionnaire and the time relative to initial HZ diagnosis was not reported. EQ-5D: EuroQol 5-dimensions; EQ-5D-3 L: EuroQol 5-dimensions 3-level; HRQoL: health-related quality of life; HZ: herpes zoster; PHN: postherpetic neuralgia; QoL: quality of life; SD: standard deviation; SF-12: Short-Form 12 version 2.0.

Li ZW, Yin CN, Wang HT, Du WY, Wang WJ, Xue FZ, Zhao L, Cao WC. Incidence trend and disease burden of seven vaccine-preventable diseases in Shandong province, China, 2013-2017: findings from a population-based observational study. Vaccine. 2022;10:100145. doi:10.1016/j.jvacx.2022.100145.

 Web of Science ®Google Scholar

Chao DY, Chien YZ, Yeh YP, Hsu PS, Lian IB. The incidence of varicella and herpes zoster in Taiwan during a period of increasing varicella vaccine coverage, 2000-2008. Epidemiol Infect. 2012;140(6):1131–40. doi:10.1017/s0950268811001786.

 PubMed Web of Science ®Google Scholar

Shiraki K, Toyama N, Daikoku T, Yajima M. Herpes zoster and recurrent herpes zoster. Open Forum Infect Dis. 2017;4(1):ofx007. doi:10.1093/ofid/ofx007.

 PubMed Web of Science ®Google Scholar

Shiraki K, Toyama N, Tanaka K, Ito A, Yamamoto J. Effect of universal varicella vaccination and behavioral changes against coronavirus disease 2019 pandemic on the incidence of herpes zoster. J Dermatol Sci. 2021;104(3):185–92. doi:10.1016/j.jdermsci.2021.10.007.

 PubMed Web of Science ®Google Scholar

Toyama N, Shiraki K. Epidemiology of herpes zoster and its relationship to varicella in Japan: a 10-year survey of 48,388 herpes zoster cases in Miyazaki prefecture. J Med Virol. 2009;81(12):2053–8. doi:10.1002/jmv.21599.

 PubMed Web of Science ®Google Scholar

Toyama N, Shiraki K. Universal varicella vaccination increased the incidence of herpes zoster in the child-rearing generation as its short-term effect. J Dermatol Sci. 2018;92(1):89–96. doi:10.1016/j.jdermsci.2018.07.003.

 PubMed Web of Science ®Google Scholar

Kuniyoshi Y, Tokutake H, Takahashi N, Kamura A, Yasuda S, Tashiro M. Routine varicella vaccination program and hospitalization for herpes zoster in Japan. Hum Vaccin Immunother. 2021;17(11):4171–6. doi:10.1080/21645515.2021.1971014.

 PubMed Web of Science ®Google Scholar

Kim YJ, Lee CN, Lim CY, Jeon WS, Park YM. Population-based study of the epidemiology of herpes zoster in Korea. J Korean Med Sci. 2014;29(12):1706–10. doi:10.3346/jkms.2014.29.12.1706.

 PubMed Web of Science ®Google Scholar

Kwon SU, Yun SC, Kim MC, Kim BJ, Lee SH, Lee SO, Choi SH, Kim YS, Woo JH, Kim SH. Risk of stroke and transient ischaemic attack after herpes zoster. Clin Microbiol Infect. 2016;22(6):542–8. doi:10.1016/j.cmi.2016.03.003.

 PubMed Web of Science ®Google Scholar

Turner NM, MacRae J, Nowlan ML, McBain L, Stubbe MH, Dowell A. Quantifying the incidence and burden of herpes zoster in New Zealand general practice: a retrospective cohort study using a natural language processing software inference algorithm. BMJ Open. 2018;8(5):e021241. doi:10.1136/bmjopen-2017-021241.

 PubMed Web of Science ®Google Scholar

Liu B, Heywood AE, Reekie J, Banks E, Kaldor JM, McIntyre P, Newall AT, Macintyre CR. Risk factors for herpes zoster in a large cohort of unvaccinated older adults: a prospective cohort study. Epidemiol Infect. 2015;143(13):2871–81. doi:10.1017/s0950268814003653.

 PubMed Web of Science ®Google Scholar

Qian J, Macartney K, Heywood AE, Sheridan S, Liu B. Risk of recurrent herpes zoster in a population-based cohort study of older adults. J Am Acad Dermatol. 2021;85(3):611–8. doi:10.1016/j.jaad.2020.06.1013.

 PubMed Web of Science ®Google Scholar

Lin J, Dobbins T, Wood JG, Bernardo C, Stocks NP, Liu B. Effectiveness of the live-attenuated herpes zoster vaccine 2 years after its introduction in Australia. Vaccine. 2021;39(10):1493–8. doi:10.1016/j.vaccine.2021.01.067.

 PubMed Web of Science ®Google Scholar

Lin J, Dobbins T, Wood JG, Bernardo C, Stocks NP, Liu B. Impact of a national immunisation program on herpes zoster incidence in Australia. J Infect. 2022;84(4):537–41. doi:10.1016/j.jinf.2022.01.011.

 PubMed Web of Science ®Google Scholar

Zhu Q, Zheng H, Qu H, Deng H, Zhang J, Ma W, Lin Y, Xie X, Qiu Q, Huang Z. Epidemiology of herpes zoster among adults aged 50 and above in Guangdong, China. Hum Vaccin Immunother. 2015;11(8):2113–8. doi:10.1080/21645515.2015.1016672.

 PubMed Web of Science ®Google Scholar

Sun X, Wei Z, Lin H, Jit M, Li Z, Fu C. Incidence and disease burden of herpes zoster in the population aged ≥50 years in China: data from an integrated health care network. J Infect. 2021;82(2):253–60. doi:10.1016/j.jinf.2020.12.013.

 PubMed Web of Science ®Google Scholar

Li Y, An Z, Yin D, Liu Y, Huang Z, Xu J, Ma Y, Tu Q, Li Q, Wang H. et al. Disease burden due to herpes zoster among population aged ≥50 years old in China: a community based retrospective survey. PloS One. 2016;11(4):e0152660. doi:10.1371/journal.pone.0152660.

 PubMed Web of Science ®Google Scholar

Lu L, Suo L, Li J, Pang X. A retrospective survey on herpes zoster disease burden and characteristics in Beijing, China. Hum Vaccin Immunother. 2018;14(11):2632–5. doi:10.1080/21645515.2018.1489193.

 PubMed Web of Science ®Google Scholar

Takao Y, Miyazaki Y, Okeda M, Onishi F, Yano S, Gomi Y, Ishikawa T, Okuno Y, Mori Y, Asada H. et al. Incidences of herpes zoster and postherpetic neuralgia in Japanese adults aged 50 years and older from a community-based prospective cohort study: the SHEZ study. J Epidemiol. 2015;25(10):617–25. doi:10.2188/jea.JE20140210.

 PubMed Web of Science ®Google Scholar

Nakamura Y, Miyagawa F, Okazaki A, Okuno Y, Mori Y, Iso H, Yamanishi K, Asada H. Clinical and immunologic features of recurrent herpes zoster (HZ). J Am Acad Dermatol. 2016;75(5):950–6.e951. doi:10.1016/j.jaad.2016.05.037.

 PubMed Web of Science ®Google Scholar

Sato K, Adachi K, Nakamura H, Asano K, Watanabe A, Adachi R, Kiuchi M, Kobayashi K, Matsuki T, Kaise T. et al. Burden of herpes zoster and postherpetic neuralgia in Japanese adults 60 years of age or older: results from an observational, prospective, physician practice-based cohort study. J Dermatol. 2017;44(4):414–22. doi:10.1111/1346-8138.13639.

 PubMed Web of Science ®Google Scholar

Yamada K, Kubota Y, Shimizu Y, Cui R, Mori Y, Okuno Y, Asada H, Yamanishi K, Iso H. Sleep shortage is associated with postherpetic neuralgia development through hyperesthesia and acute pain intensity: a community-based prospective cohort study. Pain Pract. 2019;19(5):476–83. doi:10.1111/papr.12766.

 PubMed Web of Science ®Google Scholar

Kawahira K, Imano H, Yamada K, Takao Y, Mori Y, Asada H, Okuno Y, Yamanishi K, Iso H. Risk of herpes zoster in relation to body mass index among residents aged ≥50 years: the Shozu herpes zoster study. J Epidemiol. 2022;32(8):370–5. doi:10.2188/jea.JE20200473.

 PubMed Web of Science ®Google Scholar

Imafuku S, Matsuki T, Mizukami A, Goto Y, de Souza S, Jégou C, Bianco V, Rosillon D, Ito C, Curran D. et al. Burden of herpes zoster in the Japanese population with immunocompromised/chronic disease conditions: results from a cohort study claims database from 2005-2014. Dermatol Ther (Heidelb). 2019;9(1):117–33. doi:10.1007/s13555-018-0268-8.

 PubMed Web of Science ®Google Scholar

Kobayashi D, Shimbo T, Noto H, Eto H, Takahashi O, Higuchi T. Low level of hemoglobin A1c and the increased incidence of herpes zoster: longitudinal study. Eur J Clin Microbiol Infect Dis. 2019;38(8):1539–45. doi:10.1007/s10096-019-03584-1.

 PubMed Web of Science ®Google Scholar

Ha JW, Lee JY, Her Y, Kim CW, Kim SS. Frequency of herpes zoster recurrence in central district of Korea. Ann Dermatol. 2017;29(5):602–7. doi:10.5021/ad.2017.29.5.602.

 PubMed Web of Science ®Google Scholar

Bae S, Yun SC, Kim MC, Yoon W, Lim JS, Lee SO, Choi SH, Kim YS, Woo JH, Kim SY. et al. Association of herpes zoster with dementia and effect of antiviral therapy on dementia: a population-based cohort study. Eur Arch Psychiatry Clin Neurosci. 2021;271(5):987–97. doi:10.1007/s00406-020-01157-4.

 PubMed Web of Science ®Google Scholar

Cho SI, Lee DH, Park YM. Identification of herpes zoster high-risk group using Charlson comorbidity index: a nationwide retrospective cohort study. J Dermatol. 2020;47(1):47–53. doi:10.1111/1346-8138.15115.

 PubMed Web of Science ®Google Scholar

Choi JK, Park SH, Park S, Cho SY, Lee HJ, Kim SH, Choi SM, Lee DG, Choi JH, Yoo JH. The changing epidemiology of herpes zoster over a decade in South Korea, 2006-2015. Vaccine. 2019;37(36):5153–60. doi:10.1016/j.vaccine.2019.07.086.

 PubMed Web of Science ®Google Scholar

Choi JK, Park SH, Park S, Choi SM, Kim SH, Lee DG, Yoo JH, Choi JH, Kang JH. Trends in varicella and herpes zoster epidemiology before and after the implementation of universal one-dose varicella vaccination over one decade in South Korea, 2003-2015. Hum Vaccin Immunother. 2019;15(11):2554–60. doi:10.1080/21645515.2019.1603985.

 PubMed Web of Science ®Google Scholar

Kim YJ, Lee CN, Lee MS, Lee JH, Lee JY, Han K, Park YM. Recurrence rate of herpes zoster and its risk factors: a population-based cohort study. J Korean Med Sci. 2019;34(2):e1. doi:10.3346/jkms.2019.34.e1.

 PubMed Web of Science ®Google Scholar

Wu PY, Wu HD, Chou TC, Sung FC. Varicella vaccination alters the chronological trends of herpes zoster and varicella. PloS One. 2013;8(10):e77709. doi:10.1371/journal.pone.0077709.

 PubMed Web of Science ®Google Scholar

Lu WH, Lin CW, Wang CY, Chen LK, Hsiao FY. Epidemiology and long-term disease burden of herpes zoster and postherpetic neuralgia in Taiwan: a population-based, propensity score-matched cohort study. BMC Public Health. 2018;18(1):369. doi:10.1186/s12889-018-5247-6.

 PubMed Web of Science ®Google Scholar

Jih JS, Chen YJ, Lin MW, Chen YC, Chen TJ, Huang YL, Chen CC, Lee DD, Chang YT, Wang WJ. et al. Epidemiological features and costs of herpes zoster in Taiwan: a national study 2000 to 2006. Acta Derm Venereol. 2009;89(6):612–6. doi:10.2340/00015555-0729.

 PubMed Web of Science ®Google Scholar

Heywood AE, Wang H, Macartney KK, McIntyre P. Varicella and herpes zoster hospitalizations before and after implementation of one-dose varicella vaccination in Australia: an ecological study. Bull World Health Organ. 2014;92(8):593–604. doi:10.2471/blt.13.132142.

 PubMed Web of Science ®Google Scholar

Stein AN, Britt H, Harrison C, Conway EL, Cunningham A, Macintyre CR. Herpes zoster burden of illness and health care resource utilisation in the Australian population aged 50 years and older. Vaccine. 2009;27(4):520–9. doi:10.1016/j.vaccine.2008.11.012.

 PubMed Web of Science ®Google Scholar

Carville KS, Riddell MA, Kelly HA. A decline in varicella but an uncertain impact on zoster following varicella vaccination in Victoria, Australia. Vaccine. 2010;28(13):2532–8. doi:10.1016/j.vaccine.2010.01.036.

 PubMed Web of Science ®Google Scholar

MacIntyre R, Stein A, Harrison C, Britt H, Mahimbo A, Cunningham A, Thompson R. Increasing trends of herpes zoster in Australia. PloS One. 2015;10(4):e0125025. doi:10.1371/journal.pone.0125025.

 PubMed Web of Science ®Google Scholar

Sheel M, Beard FH, Dey A, Macartney K, McIntyre PB. Rates of hospitalisation for herpes zoster may warrant vaccinating Indigenous Australians under 70. Med J Aust. 2017;207(9):395–6. doi:10.5694/mja16.01468.

 PubMed Web of Science ®Google Scholar

Sheel M, Beard F, Quinn H, Dey A, Kirk M, Koehler A, Markey P, McIntyre P, Macartney K. Australian vaccine preventable disease epidemiological review series: varicella-zoster virus infections, 1998-2015. Commun Dis Intell. 2018;42:S2209–6051(2218)00002–00007.

 Google Scholar

Chan DYW, Edmunds WJ, Chan HL, Chan V, Lam YCK, Thomas SL, van Hoek AJ, Flasche S. The changing epidemiology of varicella and herpes zoster in Hong Kong before universal varicella vaccination in 2014. Epidemiol Infect. 2018;146(6):723–34. doi:10.1017/s0950268818000444.

 PubMed Web of Science ®Google Scholar

Wan EYF, Chui CSL, Wang Y, Ng VWS, Yan VKC, Lai FTT, Li X, Wong CKH, Chan EWY, Wong CSM. et al. Herpes zoster related hospitalization after inactivated (CoronaVac) and mRNA (BNT162b2) SARS-CoV-2 vaccination: a self-controlled case series and nested case-control study. Lancet Reg Health West Pac. 2022;21:100393. doi:10.1016/j.lanwpc.2022.100393.

 PubMedGoogle Scholar

Choi WS, Noh JY, Huh JY, Jo YM, Lee J, Song JY, Kim WJ, Cheong HJ. Disease burden of herpes zoster in Korea. J Clin Virol. 2010;47(4):325–9. doi:10.1016/j.jcv.2010.01.003.

 PubMed Web of Science ®Google Scholar

Lin YH, Huang LM, Chang IS, Tsai FY, Lu CY, Shao PL, Chang LY. Disease burden and epidemiology of herpes zoster in pre-vaccine Taiwan. Vaccine. 2010;28(5):1217–20. doi:10.1016/j.vaccine.2009.11.029.

 PubMed Web of Science ®Google Scholar

Nakamura H, Mizukami A, Adachi K, Matthews S, Holl K, Asano K, Watanabe A, Adachi R, Kiuchi M, Kobayashi K, et al. Economic burden of herpes zoster and post-herpetic neuralgia in adults 60 years of age or older: results from a prospective, physician practice-based cohort study in Kushiro, Japan. Drugs Real World Outcomes. 2017;4(4):187–98. doi:10.1007/s40801-017-0119-4.

 PubMedGoogle Scholar

Ming WK, Yu WY, Tsang OT, Chan PK, You JH. Economic analysis of herpes zoster in a hospital setting in Hong Kong. Acta Derm Venereol. 2019;99(6):616–7. doi:10.2340/00015555-3118.

 PubMed Web of Science ®Google Scholar

MacIntyre CR, Chu CP, Burgess MA. Use of hospitalization and pharmaceutical prescribing data to compare the prevaccination burden of varicella and herpes zoster in Australia. Epidemiol Infect. 2003;131(1):675–82. doi:10.1017/s0950268803008690.

 PubMed Web of Science ®Google Scholar

Kim SH, Choi SM, Kim BC, Choi KH, Nam TS, Kim JT, Lee SH, Park MS, Kim SJ. Risk factors for aseptic meningitis in herpes zoster patients. Ann Dermatol. 2017;29(3):283–7. doi:10.5021/ad.2017.29.3.283.

 PubMed Web of Science ®Google Scholar

Reid JS, Ah Wong B. Herpes zoster (shingles) at a large New Zealand general practice: incidence over 5 years. N Z Med J. 2014;127:56–60.

 PubMedGoogle Scholar

Chen Q, Hsu T-Y, Chan R, Kawai K, Acosta CJ, Walia A, Pan JY. Clinical and economic burden of herpes zoster and postherpetic neuralgia in patients from the National Skin Centre, Singapore. Dermatol Sin. 2015;33(4):201–5. doi:10.1016/j.dsi.2015.04.002.

 Web of Science ®Google Scholar

Niederer RL, Meyer JJ, Liu K, Danesh-Meyer HV. Herpes zoster ophthalmicus clinical presentation and risk factors for loss of vision. Am J Ophthalmol. 2021;226:83–9. doi:10.1016/j.ajo.2021.02.002.

 PubMed Web of Science ®Google Scholar

Szeto SK, Chan TC, Wong RL, Ng AL, Li EY, Jhanji V. Prevalence of ocular manifestations and visual outcomes in patients with herpes zoster ophthalmicus. Cornea. 2017;36(3):338–42. doi:10.1097/ico.0000000000001046.

 PubMed Web of Science ®Google Scholar

Tang J, Tao J, Luo G, Zhu J, Yao M. Analysis of risk factors and construction of a prediction model of motor dysfunction caused by limb herpes zoster. J Pain Res. 2022;15:367–75. doi:10.2147/jpr.S346564.

 PubMed Web of Science ®Google Scholar

Karki S, Newall AT, MacIntyre CR, Heywood AE, McIntyre P, Banks E, Liu B. Healthcare resource utilisation associated with herpes zoster in a prospective cohort of older Australian adults. PloS One. 2016;11(8):e0160446. doi:10.1371/journal.pone.0160446.

 PubMed Web of Science ®Google Scholar

Yu SY, Fan BF, Yang F, DiBonaventura M, Chen YX, Li RY, King-Concialdi K, Kudel I, Hlavacek P, Hopps M. et al. Patient and economic burdens of postherpetic neuralgia in China. Clinicoecon Outcomes Res. 2019;11:539–50. doi:10.2147/ceor.S203920.

 PubMed Web of Science ®Google Scholar

Hashizume H, Nakatani E, Sato Y, Goto H, Yagi H, Miyachi Y. A new susceptibility index to predict the risk of severe herpes zoster-associated pain: a Japanese regional population-based cohort study, the Shizuoka study. J Dermatol Sci. 2022;105(3):170–5. doi:10.1016/j.jdermsci.2022.02.006.

 PubMed Web of Science ®Google Scholar

Ishikawa Y, Nakano K, Tokutsu K, Nakayamada S, Matsuda S, Fushimi K, Tanaka Y. Short-term prognostic factors in hospitalized herpes zoster patients and its associated cerebro-cardiovascular events: a nationwide retrospective cohort in Japan. Front Med. 2022;9:843809. doi:10.3389/fmed.2022.843809.

 Web of Science ®Google Scholar

Cheong C, Lee TJ. Prevalence and healthcare utilization of herpes zoster and postherpetic neuralgia in South Korea: disparity among patients with different immune statuses. Epidemiol Health. 2014;36:e2014012. doi:10.4178/epih/e2014012.

 PubMedGoogle Scholar

Choi WS, Kwon SS, Lee J, Choi SM, Lee JS, Eom JS, Sohn JW, Choeng HJ. Immunity and the burden of herpes zoster. J Med Virol. 2014;86(3):525–30. doi:10.1002/jmv.23830.

 PubMed Web of Science ®Google Scholar

Song H, Lee J, Lee M, Choi WS, Choi JH, Lee MS, Hashemi M, Rampakakis E, Kawai K, White R. et al. Burden of illness, quality of life, and healthcare utilization among patients with herpes zoster in South Korea: a prospective clinical-epidemiological study. Int J Infect Dis. 2014;20:23–30. doi:10.1016/j.ijid.2013.11.018.

 PubMed Web of Science ®Google Scholar

Hong MJ, Kim YD, Cheong YK, Park SJ, Choi SW, Hong HJ. Epidemiology of postherpetic neuralgia in Korea: an electronic population health insurance system based study. Medicine (Baltimore). 2016;95(14):e3304. doi:10.1097/md.0000000000003304.

 PubMed Web of Science ®Google Scholar

Tsai TF, Yao CA, Yu HS, Lan CC, Chao SC, Yang JH, Yang KC, Chen CY, White RR, Psaradellis E. et al. Herpes zoster-associated severity and duration of pain, health-related quality of life, and healthcare utilization in Taiwan: a prospective observational study. Int J Dermatol. 2015;54(5):529–36. doi:10.1111/ijd.12484.

 PubMed Web of Science ®Google Scholar

Honda M, Murata T, Ebata N, Fujii K, Ogawa S. Treatment patterns of postherpetic neuralgia patients before and after the launch of pregabalin and its effect on medical costs: analysis of Japanese claims data provided by Japan medical data center. J Dermatol. 2017;44(7):767–73. doi:10.1111/1346-8138.13784.

 PubMed Web of Science ®Google Scholar

Mizukami A, Sato K, Adachi K, Matthews S, Holl K, Matsuki T, Kaise T, Curran D. Impact of herpes zoster and post-herpetic neuralgia on health-related quality of life in Japanese adults aged 60 years or older: results from a prospective, observational cohort study. Clin Drug Investig. 2018;38(1):29–37. doi:10.1007/s40261-017-0581-5.

 PubMed Web of Science ®Google Scholar

Data availability statement

This systematic literature review protocol was not registered. Data sharing of anonymized subject level data is not applicable to this article. All data supporting the findings of this study were obtained from the references cited.