The sequelae of herpes zoster

Arch Intern Med. 1997 Jun 9;157(11):1209-13.


Background: The last 40 years was a period during which the incidence of herpes zoster appears to have increased substantially.

Objective: To determine whether the risk of complications of herpes zoster has changed during the last 40 years.

Methods: The automated medical records of a health maintenance organization were screened for diagnosis codes suggesting herpes zoster and potentially complicated cases of zoster. The predictive value of a herpes zoster diagnosis was calculated from sampling full-text records. Records of all patients with codes suggesting complications were reviewed in full.

Results: Of 859 individuals with herpes zoster who met the eligibility criteria, 101 were identified who experienced at least 1 complication, corresponding to a 60-day risk of 12%. Corrected for the sensitivity of the complication-finding strategy, the risk estimate was 14%. Risk increased markedly with age, with those older than 64 years having more than 6 times the risk of complications of those younger than 25 years (odds ratio, 8.3; 95% confidence interval, 2.5-29.3). Trigeminal distribution of rash and the presence of certain conditions associated with immune compromise appeared to increase risk.

Conclusions: The apparent increase in the incidence of herpes zoster was not accompanied by a change in the risk of specific or overall complications in a population-based sample. Advanced age and other conditions associated with waning cellular immunity may confer an increased risk of experiencing a complicated course of herpes zoster.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Cohort Studies
  • Comorbidity
  • Female
  • Health Maintenance Organizations
  • Herpes Zoster / complications*
  • Herpes Zoster / epidemiology
  • Humans
  • Incidence
  • Male
  • Medical Records
  • Middle Aged
  • Neuralgia / epidemiology
  • Neuralgia / virology*
  • Predictive Value of Tests
  • Risk Factors
  • Sampling Studies
  • Sensitivity and Specificity