The Epidemiology of Herpes Zoster in Immunocompetent, Unvaccinated Adults ≥50 Years Old: Incidence, Complications, Hospitalization, Mortality, and Recurrence
The Epidemiology of Herpes Zoster in Immunocompetent, Unvaccinated Adults ≥50 Years Old: Incidence, Complications, Hospitalization, Mortality, and Recurrence
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DOI：
10.1093/infdis/jiz652
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发表时间：
2020-09-01
影响因子：
6.4
通讯作者：
Sy, Lina S.
中科院分区：
文献类型：
--
作者：
Tseng, Hung Fu;Bruxvoort, Katia;Sy, Lina S.
背景资料。需要关于带状疱疹(HZ)流行病学的数据，特别是在未接种疫苗的免疫能力人群中，以评估疾病负担和接种疫苗的潜在影响。这项在一家大型医疗机构进行的研究包括：(1)2011-2015年发生HZ的免疫能力正常的成年人的发病率估计；(2)2011-2015年发生HZ事件的600名事件患者中未接种带状疱疹疫苗活疫苗的50年；(2)2011-2015年间600名事件患者的HZ相关非疼痛并发症的比例；(3)2015年确诊的HZ患者中与HZ相关的住院情况；(4)根据自动化数据和EHR确定的与HZ相关的死亡；以及(5)从2007-2008年首次诊断为HZ的队列中发现的复发HZ。赫兹发病率为9.92/1000人年(95%可信区间为9.82~10.01)。皮肤、神经和其他并发症的比例分别为6.40%(95%CI，1.73%~11.07%)、0.77%(95%CI，0.00%~2.36%)和1.01%(95%CI，0.00%~2.93%)。只有0.86%的患者有与HZ相关的住院治疗。病死率为0.04%。复发率为10.96/1000人年(95%CI，10.18~11.79)，10年复发风险为10.26%(95%CI，9.36%~11.23%)。这些最近在免疫能力强、未接种疫苗的人群中的HZ流行病学数据衡量了现实世界的疾病负担。
Background. Data on the epidemiology of herpes zoster (HZ), particularly in the unvaccinated immunocompetent population, are needed to assess disease burden and the potential impact of vaccination.Methods. The study at a large health care organization comprised: (1) incidence estimated from immunocompetent adults aged >= 50 years unvaccinated with zoster vaccine live who had incident HZ in 2011-2015; (2) proportion of HZ-related nonpain complications assessed by double abstraction of electronic health records (EHRs) of 600 incident patients 2011-2015; (3) HZ-related hospitalizations among HZ patients diagnosed in 2015; (4) HZ-related death determined from automated data and EHRs; and (5) recurrent HZ identified from a cohort initially diagnosed with HZ in 2007-2008 and followed through 2016.Results. HZ incidence rate was 9.92/1000 person-years (95% confidence interval [CI], 9.82-10.01). Proportions of cutaneous, neurologic, and other complications were 6.40% (95% CI,1.73%-11.07%), 0.77% (95% CI, .00%-2.36%), and 1.01% (95% CI, .00%-2.93%), respectively. Only 0.86% of patients had an HZ-related hospitalization. The case-fatality rate was 0.04%. Recurrence rate was 10.96/1000 person-years (95% CI, 10.18-11.79) with 10-year recurrence risk of 10.26% (95% CI, 9.36%-11.23%).Conclusions. These recent HZ epidemiology data among an immunocompetent, unvaccinated population measure real-world disease burden.