Risk factors for herpes zoster in a large cohort of unvaccinated older adults a prospective cohort study

• Published in: Epidemiology and infection Vol. 143; no. 13; pp. 2871 - 2881
• Main Authors: LIU, B., HEYWOOD, A. E., REEKIE, J., BANKS, E., KALDOR, J. M., McINTYRE, P., NEWALL, A. T., MACINTYRE, C. R.
• Format: Journal Article
• Language: English
• Published: England Cambridge University Press 01.10.2015
• Subjects: Adults; Aged; Cancer; Chicken pox; Demographics; Epidemiology; Exercise; Female; Herpes viruses; Herpes Zoster - epidemiology; Hospitalization; Humans; Male; Medical screening; Medicare; Middle Aged; New South Wales - epidemiology; Older people; Original Papers; Population; Prospective Studies; Questionnaires; Research ethics; Risk Factors; Sociodemographics; Vaccines; Varicella Zoster; New South Wales; Australia; Herpes zoster; risk factors; prospective study; shingles; vaccination
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/s0950268814003653

We analysed data from a prospective cohort of 255024 adults aged ⩾45 years recruited from 2006–2009 to identify characteristics associated with a zoster diagnosis. Diagnoses were identified by linkage to pharmaceutical treatment and hospitalization records specific for zoster and hazard ratios were estimated. Over 940583 person-years, 7771 participants had a zoster diagnosis; 253 (3·3%) were hospitalized. After adjusting for age and other factors, characteristics associated with zoster diagnoses included: having a recent immunosuppressive condition [adjusted hazard ratio (aHR) 1·58, 95% confidence interval (CI) 1·32–1·88], female sex (aHR 1·36, 95% CI 1·30–1·43), recent cancer diagnosis (aHR 1·35, 95% CI 1·24–1·46), and severe physical limitation vs. none (aHR 1·33, 95% CI 1·23–1·43). The relative risk of hospitalization for zoster was higher for those with an immunosuppressive condition (aHR 3·78, 95% CI 2·18–6·55), those with cancer (aHR 1·78, 95% CI 1·24–2·56) or with severe physical limitations (aHR 2·50, 95% CI 1·56–4·01). The novel finding of an increased risk of zoster diagnoses and hospitalizations in those with physical limitations should prompt evaluation of the use of zoster vaccine in this population.