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Infectious Diseases and Therapy

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Open Access 24-04-2024 | Shingles | Original Research

Systematic Literature Review on the Incidence of Herpes Zoster in Populations at Increased Risk of Disease in the EU/EEA, Switzerland, and the UK

Authors: Alen Marijam, Nikki Vroom, Amit Bhavsar, Inga Posiuniene, Nicolas Lecrenier, Hilde Vroling

Published in: Infectious Diseases and Therapy | Issue 5/2024

Abstract

Introduction

Older adults and patients with underlying conditions such as immunocompromised (IC) populations (e.g., due to medical conditions or immunosuppressive medication) are at increased risk for herpes zoster (HZ). The first HZ recombinant vaccine for IC patients was approved in 2020. Limited evidence exists to inform decision-makers on HZ incidence in high-risk patients in Europe. This systematic literature review (SLR) assessed HZ incidence across 14 high-risk populations in the European Union/European Economic Area, Switzerland, and the United Kingdom.

Methods

An SLR (Embase, Medline, 2002–2022, observational studies) was performed to identify HZ incidence (i.e., primary outcomes: rate or cumulative; secondary: relative incidence) in type 1 and 2 diabetes mellitus (DM); chronic obstructive pulmonary disease and asthma; depression; rheumatic disorders (RD); multiple sclerosis (MS); inflammatory bowel diseases (IBD); psoriasis; lupus; human immunodeficiency virus (HIV); solid organ transplantation (SOT); solid organ malignancy (SOM); hematologic malignancy (HM); and stem cell transplantation (SCT).

Results

Of 776 unique records screened, 59 studies were included (24 reported incidence rate per 1000 person-years; two, cumulative incidence per 1000 persons; and 33, relative incidence). The highest incidence rates were reported for SOT (12.1–78.8) and SCT (37.2–56.1); HM (2.9–32.0); RD (0.41–21.5); lupus (11.0–16.5); IC mixed population (11.3–15.5); HIV/AIDS (11.8–13.0); chronic respiratory diseases (4.7–11.4); SOM (8.8–11.0); IBD (7.0–10.8); DM (4.3–9.4); depression (7.2–7.6); MS (5.7–6.3); and psoriasis (5.3–6.1). In many high-risk populations, HZ incidence was higher for older age groups, women, and some treatments.

Conclusions

The HZ incidence rate in Europe increased with age and varied across high-risk populations, with high rates for solid organ and stem cell transplants, cancer, and rheumatoid arthritis. Most studies were retrospective with methodological differences affecting generalizability and comparability. Future studies should stratify data by IC population, age, sex, severity, medication, and study timeframe.

Available only for authorised users

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Title: Systematic Literature Review on the Incidence of Herpes Zoster in Populations at Increased Risk of Disease in the EU/EEA, Switzerland, and the UK
Authors: Alen Marijam
Nikki Vroom
Amit Bhavsar
Inga Posiuniene
Nicolas Lecrenier
Hilde Vroling
Publication date: 24-04-2024
Publisher: Springer Healthcare
Keywords: Shingles
Rheumatoid Arthritis
Vulgar Psoriasis
Chronic Inflammatory Bowel Disease
Human Immunodeficiency Virus
Stem Cell Transplantation
Stem Cell Transplantion
Stem Cell Transplantation
Multiple Sclerosis
Chronic Obstructive Lung Disease
Published in: Infectious Diseases and Therapy / Issue 5/2024
Print ISSN: 2193-8229
Electronic ISSN: 2193-6382
DOI: https://doi.org/10.1007/s40121-024-00963-w

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