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Cross-sectional study on hospitalizations related to herpes zoster in an Italian region, 2008–2016

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Abstract

Introduction

To assess the burden of herpes zoster (HZ) by analyzing HZ-related hospital admissions.

Methods

We conducted a population-based descriptive cross-sectional study on all hospitalizations for HZ among the resident population admitted to all public and accredited private hospitals in the Veneto Region (north-east Italy) during the years 2008–2016. HZ hospitalizations were identified from the International Classification of Diseases codes in the hospital discharge records.

Results

During the period considered, we identified 3566 HZ-associated admissions, 194 (5.4%) of which were readmissions within 30 days. A complicated HZ diagnosis was mentioned for 44.4% of the patients admitted once and for 65.9% of those admitted twice. In the sample as a whole, 27.0% of patients had at least one comorbidity. Overall, our analysis revealed a gradual increase in hospitalizations with age for both genders, reaching a hospitalization rate for the population over 80 years old of 51.2 × 100,000 for males and 52.8 × 100,000 for females. The average hospitalization rate for HZ-related conditions during the years 2008–2016 was 7.7 per 100,000 population. Postherpetic neuralgia was diagnosed in 8.2% of hospitalizations, with no difference between the genders. The estimated overall cost of HZ-related conditions was approximately €2.7 million a year.

Conclusions

This study suggests that the burden of HZ and its impact on quality of life are of critical relevance to public health decision-making.

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Abbreviations

HZ:

Herpes zoster

VZV:

Varicella zoster virus

CMI:

Cell-mediated immunity

COPD:

Chronic obstructive pulmonary disease

PHN:

Postherpetic neuralgia

ICD-9-CM:

International Classification of Diseases, Ninth Revision, Clinical Modification

DRG:

Diagnosis-related groups

AAPC:

Average annual percent changes

References

  1. Harpaz R, Ortega-Sanchez IR, Seward JF (2008) Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 57:1–30

    PubMed  Google Scholar 

  2. Esteban-Vasallo MD, Domínguez-Berjón MF, Gil-Prieto R et al (2015) Temporal trends in herpes zoster-related hospitalizations in Madrid (Spain), 2003–2013. J Infect 71:85–92

    Article  PubMed  Google Scholar 

  3. Gilden D, Nagel M, Cohrs R et al (2015) Varicella Zoster virus in the nervous system. F1000Research. https://doi.org/10.12688/f1000research.7153.1

    Article  PubMed  PubMed Central  Google Scholar 

  4. Gabutti G, Penna C, Rossi M et al (2001) The seroepidemiology of varicella in Italy. Epidemiol Infect 126:433–440

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Pinchinat S, Cebrián-Cuenca AM, Bricout H et al (2013) Similar herpes zoster incidence across Europe: results from a systematic literature review. BMC Infect Dis 13:170

    Article  PubMed  PubMed Central  Google Scholar 

  6. Maggi S, Gabutti G, Franco F et al (2015) Preventing and managing herpes zoster: key actions to foster healthy aging. Aging Clin Exp Res 27:5–11

    Article  PubMed  Google Scholar 

  7. Gnann JW, Whitley RJ (2002) Clinical practice. Herpes zoster. N Engl J Med 347:340–346

    Article  PubMed  Google Scholar 

  8. Guignard AP, Greenberg M, Lu C et al (2014) Risk of herpes zoster among diabetics: a matched cohort study in a US insurance claim database before introduction of vaccination, 1997–2006. Infection 42:729–735

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Yang YW, Chen YH, Wang KH et al (2011) Risk of herpes zoster among patients with chronic obstructive pulmonary disease: a population-based study. CMAJ 22:183: E275-80

    Google Scholar 

  10. McDonald JR, Zeringue AL, Caplan L et al (2009) Herpes zoster risk factors in a national cohort of veterans with rheumatoid arthritis. Clin Infect Dis 48:1364–1371

    Article  PubMed  PubMed Central  Google Scholar 

  11. Hata A, Kuniyoshi M, Ohkusa Y (2011) Risk of Herpes zoster in patients with underlying diseases: a retrospective hospital-based cohort study. Infection 39:537–544

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Johnson RW, Rice ASC (2014) Clinical practice. Postherpetic neuralgia. N Engl J Med 371:1526–1533

    Article  CAS  PubMed  Google Scholar 

  13. Alicino C, Trucchi C, Paganino C et al (2017) Incidence of herpes zoster and post-herpetic neuralgia in Italy: results from a 3-years population-based study. Hum Vaccin Immunother 13:399–404

    Article  PubMed  Google Scholar 

  14. Kim HJ, Fay MP, Feuer EJ et al (2000) Permutation tests for joinpoint regression with applications to cancer rates. Stat Med 19:335–351

    Article  CAS  PubMed  Google Scholar 

  15. Blein C, Gavazzi G, Paccalin M et al (2015) Burden of herpes zoster: the direct and comorbidity costs of herpes zoster events in hospitalized patients over 50 years in France. BMC Infect Dis 15:350

    Article  PubMed  PubMed Central  Google Scholar 

  16. Studahl M, Petzold M, Cassel T (2013) Disease burden of herpes zoster in Sweden—predominance in the elderly and in women—a register based study. BMC Infect Dis 13:586

    Article  PubMed  PubMed Central  Google Scholar 

  17. Levi M, Bellini I, Capecchi L et al (2015) The burden of disease of Herpes Zoster in Tuscany. Hum Vaccin Immunother 11:185–191

    Article  PubMed  Google Scholar 

  18. Johnson RW, Alvarez-Pasquin M-J, Bijl M et al (2015) Herpes zoster epidemiology, management, and disease and economic burden in Europe: a multidisciplinary perspective. Ther Adv Vaccines 3:109–120

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Opstelten W, Mauritz JW, de Wit NJ et al (2002) Herpes zoster and postherpetic neuralgia: incidence and risk indicators using a general practice research database. Fam Pract 19:471–475

    Article  PubMed  Google Scholar 

  20. Johnson RW, Wasner G, Saddier P et al (2007) Postherpetic neuralgia: epidemiology, pathophysiology and management. Expert Rev Neurother 7:1581–1595

    Article  CAS  PubMed  Google Scholar 

  21. Drolet M, Brisson M, Schmader K et al (2010) Predictors of postherpetic neuralgia among patients with herpes zoster: a prospective study. J Pain 11:1211–1221

    Article  PubMed  Google Scholar 

  22. O’Connor KM, Paauw DS (2013) Herpes zoster. Med Clin North Am 97:503–522

    Article  PubMed  Google Scholar 

  23. Valente N, Cocchio S, Stefanati A et al (2017) Temporal trends in herpes zoster-related hospitalizations in Italy, 2001–2013: differences between regions that have or have not implemented varicella vaccination. Aging Clin Exp Res 29:771–779

    Article  PubMed  Google Scholar 

  24. Yih WK, Brooks DR, Lett SM et al (2005) The incidence of varicella and herpes zoster in Massachusetts as measured by the Behavioral Risk Factor Surveillance System (BRFSS) during a period of increasing varicella vaccine coverage, 1998–2003. BMC Public Health 5:68

    Article  PubMed  PubMed Central  Google Scholar 

  25. Chao DY, Chien YZ, Yeh YP et al (2012) The incidence of varicella and herpes zoster in Taiwan during a period of increasing varicella vaccine coverage, 2000–2008. Epidemiol Infect 140:1131–1140

    Article  CAS  PubMed  Google Scholar 

  26. Siedler A, Dettmann M (2014) Hospitalization with varicella and shingles before and after introduction of childhood varicella vaccination in Germany. Hum Vaccines Immunother 10:3594–3600

    Article  Google Scholar 

  27. Marinelli I, van Lier A, de Melker H et al (2017) Estimation of age-specific rates of reactivation and immune boosting of the varicella zoster virus. Epidemics 19:1–12

    Article  PubMed  Google Scholar 

  28. Jumaan AO, Yu O, Jackson LA et al (2005) Incidence of herpes zoster, before and after varicella-vaccination-associated decreases in the incidence of varicella, 1992–2002. J Infect Dis 191:2002–2007

    Article  PubMed  Google Scholar 

  29. Baldo V, Baldovin T, Russo F et al (2009) Varicella: epidemiological aspects and vaccination coverage in the Veneto Region. BMC Infect Dis 9:150

    Article  PubMed  PubMed Central  Google Scholar 

  30. Bechini A, Boccalini S, Baldo V et al (2015) Impact of universal vaccination against varicella in Italy. Hum Vaccines Immunother 11:63–71

    Article  Google Scholar 

  31. Gialloreti LE, Merito M, Pezzotti P et al (2010) Epidemiology and economic burden of herpes zoster and post-herpetic neuralgia in Italy: a retrospective, population-based study. BMC Infect Dis 10:230

    Article  PubMed  PubMed Central  Google Scholar 

  32. Friesen KJ, Falk J, Alessi-Severini S et al (2016) Price of pain: population-based cohort burden of diseases analysis of medication cost of herpes zoster and postherpetic neuralgia. J Pain Res 9:5433–5450

    Google Scholar 

  33. Valente N, Lupi S, Stefanati A et al (2016) Evaluation of the acceptability of a vaccine against herpes zoster in the over 50 years old: an Italian observational study. BMJ Open 6:e011539

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

The authors did not receive any funding or support for the manuscript.

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Authors and Affiliations

  1. Department of Cardiac, Thoracic and Vascular Sciences, Hygiene and Public Health Unit, University of Padua, Via Loredan, 18, 35121, Padua, Italy

    Silvia Cocchio, Tatjana Baldovin, Patrizia Furlan, Chiara Bertoncello, Alessandra Buja, Marco Fonzo & Vincenzo Baldo

  2. EuroHealth Net, Veneto Region Health Directorate, Veneto, Italy

    Mario Saia

Authors
  1. Silvia Cocchio
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  2. Tatjana Baldovin
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  3. Patrizia Furlan
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  4. Chiara Bertoncello
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  5. Alessandra Buja
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  6. Mario Saia
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  7. Marco Fonzo
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  8. Vincenzo Baldo
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Corresponding author

Correspondence to Chiara Bertoncello.

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Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Human and animal rights statement and consent to participate

The study was conducted on data routinely collected by the health services and linked to anonymized records that make it impossible to identify the individuals concerned. The data analysis was performed on anonymized aggregated data in the Local Health Authority registries that are recorded with the patient’s consent and can be used in aggregate form for scientific studies without further authorization (Gazzetta Ufficiale della Repubblica Italiana. 2012, 72: 47–52). This study complies with the Declaration of Helsinki and with Italian privacy law (Decree n. 196/2003 on the protection of personal data).

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Cocchio, S., Baldovin, T., Furlan, P. et al. Cross-sectional study on hospitalizations related to herpes zoster in an Italian region, 2008–2016. Aging Clin Exp Res 31, 145–150 (2019). https://doi.org/10.1007/s40520-018-0968-z

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  • DOI: https://doi.org/10.1007/s40520-018-0968-z

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