[Changes in the incidence and clinical manifestations of herpes zoster].

BACKGROUND

Shingles is the manifestation of activated latent disease caused by the varicella-herpes zoster virus. The prerequisite of its activation is a reduction of the immunity of the organism: the incidence (with some reservations) of herpes zoster in the population can be therefore considered an indicator of the general immune state. The objective of the submitted paper was to assess whether and to what extent the frequency of herpes zoster increased (whether the number of patients hospitalized at the Clinic for Infectious Diseases increased in 1974-1994, and if so, by how much).

METHODS AND RESULTS

By comparing clinical manifestations of herpes zoster in a group of 348 patients hospitalized in 1992-1994 with results of a similar investigation made in the same department in a group of 308 patients hospitalized in 1979-1983 the following was revealed: the annual numbers of treated patients with herpes zoster doubled during the last 15 years. Almost 70% of the affected patients were then and now above 60 years of age, among the patients women predominated markedly (chi 2 = 69.540), the number of malignancies increased greatly (chi 2 = 4.435), there was also a significant increase of ischaemic heart disease, hypertension (chi 2 = 39.741) etc. As to the ratio of different sites of the shingles, no significant changes were observed, while there was a significant increase of manifestations of dermal generalization (chi 2 = 36.377) and a significant increase of peripheral pareses (chi 2 = 5.615). The author explains the fact that the period of hospitalization was not longer and that there was even a significant decrease in the number of postherpetic neuralgias persisting for more than a month, by the early onset of treatment with acyclovir administered by the i.v. route.

CONCLUSIONS

The annual numbers of patients hospitalized on account of herpes zoster doubled during the past 15 years, the number of malignancies increased as well as the number of cardiovascular diseases, and the frequency of skin generalizations and peripheral pareses increased. Treatment with acyclovir had a favourable effect on the period of hospitalization.