Introduction
Methods
Data sources
Study populations
Ascertaining incident HZ cases
Identification of persistent post-zoster pain
Patient characteristics
Statistical analysis
Results
Characteristics of study sample
Characteristics of the study sample | Number of persons | Age (years) | Age group (%) | Sex | Use of immunosuppressants/chemotherapy (%) | |||||
---|---|---|---|---|---|---|---|---|---|---|
Mean | SD | 18–49 years | 50–59 years | 60–64 years | 65+ years | Male | Female | |||
Total study population | 51,022,838 | 43.1 | 15.8 | 66.0 | 19.2 | 6.2 | 8.6 | 46.0 | 54.0 | N/A |
Bone marrow or stem cell transplant | 14,679 | 49.3 | 12.8 | 42.8 | 35.3 | 15.5 | 6.5 | 52.4 | 47.6 | 58.6 |
Solid organ transplant | 61,189 | 49.7 | 12.5 | 44.5 | 34.0 | 13.1 | 8.4 | 59.2 | 40.8 | 67.4 |
Human immunodeficiency virus infection | 121,956 | 41.8 | 10.6 | 76.8 | 18.8 | 3.2 | 1.2 | 69.8 | 30.2 | N/A |
Systemic lupus erythematosus | 144,137 | 46.9 | 13.2 | 56.7 | 27.5 | 8.7 | 7.1 | 12.2 | 87.8 | 47.0 |
Rheumatoid arthritis | 571,555 | 52.7 | 13.9 | 39.4 | 31.8 | 12.7 | 16.1 | 26.7 | 73.3 | 49.4 |
Cancer | 1,462,356 | 59.5 | 13.8 | 21.8 | 30.1 | 16.6 | 31.5 | 45.1 | 54.9 | 28.7 |
Inflammatory bowel disease | 345,565 | 47.0 | 15.0 | 55.5 | 25.1 | 9.2 | 10.2 | 43.5 | 56.5 | 37.8 |
Multiple sclerosis | 146,261 | 46.3 | 12.1 | 60.1 | 27.5 | 7.2 | 5.2 | 24.1 | 75.9 | 33.0 |
Psoriasis | 536,770 | 46.2 | 14.7 | 57.2 | 24.8 | 9.1 | 8.9 | 45.6 | 54.4 | 30.3 |
Incidence rate of HZ
Characteristics of the study sample | Number of herpes zoster cases | Person-years | Incidencea
| 95 % Confidence interval | Incidence by use of immunosuppressants or chemotherapy | |||
---|---|---|---|---|---|---|---|---|
Users | Non-users | |||||||
Incidencea
| 95 % CI | Incidencea
| 95 % CI | |||||
Total study population | 435,378 | 90,236,779 | 4.82 | 4.81–4.84 | N/A |
–
| N/A |
–
|
Bone marrow or stem cell transplant | 726 | 16,870 | 43.03 | 39.96–46.28 | 51.50 | (47.18–56.11) | 30.23 | 26.21–34.68 |
Solid organ transplant | 1,673 | 98,173 | 17.04 | 16.23–17.88 | 18.85 | (17.86–19.89) | 12.11 | 10.82–13.52 |
Human immunodeficiency virus infection | 3,207 | 184,198 | 17.41 | 16.81–18.01 | N/A | – | N/A | – |
Systemic lupus erythematosus | 3,540 | 233,096 | 15.19 | 14.69–15.69 | 17.85 | (17.11–18.61) | 12.23 | 11.58–12.90 |
Rheumatoid arthritis | 11,446 | 934,811 | 12.24 | 12.02–12.47 | 14.28 | (13.96–14.61) | 9.64 | 9.34–9.94 |
Cancer | 29,698 | 2,538,706 | 11.70 | 11.57–11.83 | 15.63 | (15.33–15.93) | 10.25 | 10.11–10.40 |
Inflammatory bowel disease | 5,257 | 564,563 | 9.31 | 9.06–9.56 | 12.07 | (11.64–12.51) | 7.15 | 6.86–7.45 |
Multiple sclerosis | 2,146 | 249,551 | 8.60 | 8.24–8.96 | 11.00 | (10.35–11.68) | 7.05 | 6.64–7.49 |
Psoriasis | 6,927 | 862,544 | 8.03 | 7.84–8.22 | 10.85 | (10.49–11.23) | 6.47 | 6.26–6.68 |
Incidence rate ratio of HZ for patients receiving immunosuppressants or chemotherapy
Incidence rate and rate ratio of HZ by age and gender
Characteristics of the study population | Incidencea, b (95 % CI) | Incidence rate ratio (95 % CI) | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
18–49 years | 50–59 years | 60–64 years | 65+ years | 50–59 vs. 18–49 | 60–64 vs. 18–49 | 65+ vs. 18–49 | ||||||||
Total study population | 3.37 (3.35–3.38) | 6.43 (6.40–6.47) | 7.71 (7.64–7.79) | 8.43 (8.37–8.49) | 1.91 (1.90–1.92) | 2.29 (2.27–2.31) | 2.50 (2.48–2.52) | |||||||
Bone marrow or stem cell transplant | 40.20 (35.6–45.12) | 43.22 (38.2–48.65) | 50.71 (41.8–60.92) | 44.73 (33.2–58.97) | 1.08 (0.91–1.27) | 1.26 (1.01–1.57) | 1.11 (0.81–1.51) | |||||||
Solid organ transplant | 13.30 (12.2–14.43) | 19.41 (17.9–20.91) | 19.76 (17.2–22.56) | 23.15 (19.9–26.76) | 1.46 (1.30–1.63) | 1.49 (1.27–1.74) | 1.74 (1.46–2.06) | |||||||
Human immunodeficiency virus infection | 17.83 (17.1–18.55) | 16.42 (15.1–17.75) | 16.02 (12.8–19.78) | 10.70 (6.62–16.35) | 0.92 (0.84–1.01) | 0.90 (0.72–1.11) | 0.60 (0.37–0.92) | |||||||
Systemic lupus erythematosus | 13.39 (12.7–14.04) | 15.40 (14.5–16.35) | 20.01 (18.0–22.18) | 23.39 (21.0–25.91) | 1.15 (1.07–1.24) | 1.49 (1.33–1.67) | 1.75 (1.56–1.96) | |||||||
Rheumatoid arthritis | 8.32 (8.02–8.63) | 12.75 (12.3–13.15) | 15.31 (14.5–16.08) | 18.34 (17.6–19.04) | 1.53 (1.46–1.61) | 1.84 (1.73–1.96) | 2.20 (2.09–2.32) | |||||||
Cancer | 8.39 (8.15–8.64) | 10.94 (10.7–11.17) | 13.05 (12.6–13.42) | 14.14 (13.8–14.40) | 1.30 (1.26–1.35) | 1.55 (1.49–1.62) | 1.68 (1.63–1.74) | |||||||
Inflammatory bowel disease | 6.89 (6.59–7.19) | 11.02 (10.5–11.55) | 11.67 (10.7–12.69) | 15.48 (14.4–16.53) | 1.60 (1.50–1.71) | 1.69 (1.54–1.86) | 2.25 (2.08–2.43) | |||||||
Multiple sclerosis | 6.83 (6.42–7.27) | 10.75 (10.0–11.52) | 11.91 (10.2–13.75) | 12.35 (10.4–14.50) | 1.57 (1.43–1.73) | 1.74 (1.48–2.04) | 1.81 (1.51–2.15) | |||||||
Psoriasis | 5.28 (5.08–5.49) | 9.46 (9.08–9.86) | 13.11 (12.2–13.99) | 15.39 (14.5–16.27) | 1.79 (1.69–1.90) | 2.48 (2.30–2.68) | 2.91 (2.72–3.12) |
Six-month rate of persistent post-zoster pain
Characteristics of the study population | Herpes zoster cases (n) | Rate of persistent post-zoster related pain (%) | 95 % CI |
---|---|---|---|
Total study population | 322,877 | 4.29 | 4.22–4.36 |
Bone marrow or stem cell transplant | 501 | 10.18 | 7.83–13.14 |
Solid organ transplant | 1,205 | 6.72 | 5.44–8.28 |
Human immunodeficiency virus infection | 2,311 | 6.10 | 5.20–7.15 |
Systemic lupus erythematosus | 2,593 | 6.44 | 5.56–7.45 |
Rheumatoid arthritis | 8,294 | 7.22 | 6.68–7.80 |
Cancer | 21,620 | 7.03 | 6.70–7.38 |
Inflammatory bowel disease | 3,793 | 5.85 | 5.15–6.65 |
Multiple sclerosis | 1,563 | 5.57 | 4.53–6.82 |
Psoriasis | 4,978 | 5.08 | 4.51–5.73 |