AN EPIDEMIOLOGICAL ANALYSIS OF HERPES ZOSTER AMONG DIFFERENT AGE GROUPS

Elsam Koshy, MD, Hanaasha Kumar, MD and Wu Jianbo*, PhD

ABSTRACT

Introduction: Herpes zoster occurs due to the reactivation of the varicella zoster virus following a primary infection with varicella virus. Its incidence is high among the elderly and immunocompromised patients. Early management with antivirals can reduce severity and complications with herpes zoster. Vaccination for individuals above 60 years can help reduce incidence of herpes zoster. Objective: To analyze the epidemiology of Herpes zoster among different age and gender by comparing their Total hospital stay and Numeric rating scale score on admission and on discharge. Materials and Methods: A retrospective analysis was conducted in 60 patients with herpes zoster infection treated in Zhongnan hospital of Wuhan University, Wuhan, China. All patients were divided into three groups. Group I (n=20) include patients aged <30 years, Group II (n=20) include patients aged 30-60 years and Group III (n=20) include patients aged ≥60 years. A univariate analysis with multiple comparison was performed with total hospital stay, duration at presentation, Numeric rating scale on admission and on discharge. The male and female incidence was performed using chi square test. An independent t test was used to analyze total hospital stay and duration at presentation of both males and females. Results: Among the 60 cases, the total male and female involvement was shown to be non significant (p=0.63). The total hospital stay among Group I and Group II were significant (p=0.047 and p=0.011) and the duration at presentation among Group I was also significant (p=0.02). Thoracic dermatome was involved in 31.6% patients among all age groups. Hypertension was the most common underlying disease with 20% involved among all age groups. Conclusion: Herpes zoster is not a gender specific disease. Treatment with ganciclovir can reduce hospital stay only in patients less than 30 years and patients aged 30-60 years. Thoracic dermatome was most commonly involved in all patients. Ganciclovir is safe and has shown no adverse effects in any patients. Gabapentin is effective in managing pain with a good prognosis in all patients among all age groups. Combination therapy with antivirals, analgesics and neurotropic agents can reduce pain, promotes fast healing and decrease complications.

Keywords: Herpes zoster (HZ); Varicella zoster virus (VZV); Post herpetic neuralgia (PHN).