Piazza Maria Francesca, Paganino Chiara, Amicizia Daniela, Trucchi Cecilia, Orsi Andrea, Astengo Matteo, Romairone Paolo, Simonetti Simona, Icardi Giancarlo, Ansaldi Filippo
Department of Health Sciences, University of Genoa, Via Antonio Pastore 1, 16132 Genoa, Italy.
A.Li.Sa., Liguria Health Authority, Piazza della Vittoria 15, 16121 Genoa, Italy.
Vaccines (Basel). 2020 Jan 10;8(1):20. doi: 10.3390/vaccines8010020.
The effect of severe Herpes Zoster (HZ) on chronic diseases is a component of the real burden of this vaccine-preventable disease that is not commonly considered. A retrospective cohort study was conducted to assess the health burden of severe HZ in adults ≥50 years residing in Liguria Region from 2015 to 2017. Subjects hospitalized with and without HZ were matched (1:6 ratio). 437 subjects in the HZ cohort and 2622 subjects in the non-HZ cohort were enrolled. Previous immunodeficiency, autoimmune, and rare diseases are identified as main chronic conditions related to HZ hospitalization. Higher incidences of autoimmune (1.4% vs. 0.22%, = 0.002) and gastrointestinal (7.04% vs. 3.62%, = 0.015) diseases after hospitalization were observed in the HZ cohort compared to the non-HZ cohort. Significantly higher incidences were found after hospitalization versus the previous period for cardiovascular diseases (11.17% vs. 2.09%, < 0.001), cerebral vasculopathy (6.13% vs. 0.60%, < 0.001), non-arrhythmic myocardiopathy (4.31% vs. 0.59%, = 0.002), and neuropathy (2.62% vs. 0.56%, = 0.033). The HZ cohort showed a relative risk 10-fold higher for cerebral vasculopathy, 5-fold higher for cardiovascular diseases, and 7-fold higher for non-arrhythmic myocardiopathy. HZ causes a substantial impact on the chronic conditions. These data could suggest an implementation of HZ vaccination programs in the elderly and in high-risk groups.
重症带状疱疹（HZ）对慢性病的影响是这种可通过疫苗预防的疾病实际负担的一个组成部分，而这一点通常未被考虑。开展了一项回顾性队列研究，以评估2015年至2017年居住在利古里亚地区的50岁及以上成年人中重症HZ的健康负担。将因HZ住院和未因HZ住院的受试者进行匹配（比例为1:6）。HZ队列中有437名受试者，非HZ队列中有2622名受试者。既往免疫缺陷、自身免疫性疾病和罕见病被确定为与HZ住院相关的主要慢性病。与非HZ队列相比，HZ队列中住院后自身免疫性疾病（1.4%对0.22%，P = 0.002）和胃肠道疾病（7.04%对3.62%，P = 0.015）的发病率更高。与住院前相比，住院后心血管疾病（11.17%对2.09%，P < 0.001）、脑血管病（6.13%对0.60%，P < 0.001）、非心律失常性心肌病（4.31%对0.59%，P = 0.002）和神经病变（2.62%对0.56%，P = 0.033）的发病率显著更高。HZ队列中脑血管病的相对风险高10倍，心血管疾病高5倍，非心律失常性心肌病高7倍。HZ对慢性病产生重大影响。这些数据可能表明应在老年人和高危人群中实施HZ疫苗接种计划。
