Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

BMC Infectious Diseases

Review

Ming-Yueh Chou¹  Chih-Kuang Liang²  Dilip Mathai³  Liang-Yu Chen⁴  Li-Ning Peng⁵  Liang-Kung Chen⁵  Chang Won Won⁶  Taro Kojima⁷  Samsuridjal Djauzi⁸  Xiaohong Liu⁹  Philip J. H. Poi^1,10  Ki Tae Kwon^1,11  Terapong Tantawichien^1,12  Eduardo Rommel S. Poblete^1,13  Edward M. F. Leung^1,14  Hidenori Arai^1,15  Jiun Yit Pan^1,16  Stewart Reid^1,17  Hoe Nam Leong^1,18  Birong Dong^1,19 

[1] Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan;Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, No. 386 Ta-Chun 1st Rd., 81362, Kaohsiung, Taiwan;Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan;Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, No. 386 Ta-Chun 1st Rd., 81362, Kaohsiung, Taiwan;Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan;Apollo Institute of Medical Sciences and Research, Apollo Health City Campus, Jubilee Hills, 500096, Hyderabad, India;Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd., 11217, Taipei, Taiwan;Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd., 11217, Taipei, Taiwan;Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan;Department of Family Medicine, College of Medicine, Kyung Hee University, 1 Hoigi-dong, Dongdaemun-gu, 130-720, Seoul, Korea;Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Jongo, Bunkyo-ku, 113-8655, Tokyo, Japan;Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Salemba Raya No. 6, 10430, Jakarta, Indonesia;Division of Geriatrics, Department of Internal Medicine, Peking Union Medical College Hospital, 100730, Beijing, China;Division of Geriatrics, Department of Medicine, University Malaya Medical Centre, Lembah Pantai, 59100, Kuala Lumpur, Malaysia;Division of Infectious Diseases, Daegu Fatima Hospital, 99 Ayang-ro, Dong-gu, 710-600, Daegu, Korea;Division of Infectious Diseases, Department of Medicine, Chulalongkorn University, 10330, Bangkok, Thailand;Geriatric Center, St. Luke’s Medical Center, 279 E. Rodriguez Sr. Ave., 1102, Quezon City, Philippines;Geriatric Medicine Centre (Healthy Ageing), Hong Kong Sanatorium and Hospital, 2 Village Rd. Happy Valley, Hong Kong S.A.R., China;National Center for Geriatrics and Gerontology, 7-340 Morioka-cho, 474-8511, Obu, Aichi, Japan;National Skin Centre, 1 Mandalay Rd., 308205, Singapore, Singapore;Ropata Medical Centre, 5010, Lower Hutt, New Zealand;Rophi Clinic, 38 Irrawaddy Rd. #07-54/55, Mount Elizabeth Novena Specialist Centre, 329563, Singapore, Singapore;The Center of Gerontology and Geriatrics, West China Medical School/West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Renmin Nan Lu, 610041, Chengdu, Sichuan, China;

关键词: Asia-Pacific;    Complications;    Epidemiology;    Healthcare burden;    Herpes zoster;    Immunisation;    Management;    Post-herpetic neuralgia;    Prevention;    Vaccine;   

DOI  :  10.1186/s12879-017-2198-y

 received in 2016-03-05, accepted in 2017-01-09,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundHerpes zoster (HZ) is a prevalent viral disease that inflicts substantial morbidity and associated healthcare and socioeconomic burdens. Current treatments are not fully effective, especially among the most vulnerable patients. Although widely recommended, vaccination against HZ is not routine; barriers in Asia-Pacific include long-standing neglect of adult immunisation and sparse local data. To address knowledge gaps, raise awareness, and disseminate best practice, we reviewed recent data and guidelines on HZ from the Asia-Pacific region.MethodsWe searched PubMed, Scopus, and World Health Organization databases for articles about HZ published from 1994 to 2014 by authors from Australia, China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, New Zealand, the Philippines, Singapore, Taiwan, Thailand, and Vietnam. We selected articles about epidemiology, burden, complications, comorbidities, management, prevention, and recommendations/guidelines. Internet searches retrieved additional HZ immunisation guidelines.ResultsFrom 4007 retrieved articles, we screened-out 1501 duplicates and excluded 1264 extraneous articles, leaving 1242 unique articles. We found guidelines on adult immunisation from Australia, India, Indonesia, Malaysia, New Zealand, the Philippines, South Korea, and Thailand.HZ epidemiology in Asia-Pacific is similar to elsewhere; incidence rises with age and peaks at around 70 years – lifetime risk is approximately one-third. Average incidence of 3–10/1000 person-years is rising at around 5% per year. The principal risk factors are immunosenescence and immunosuppression. HZ almost always causes pain, and post-herpetic neuralgia is its most common complication. Half or more of hospitalised HZ patients have post-herpetic neuralgia, secondary infections, or inflammatory sequelae that are occasionally fatal. These disease burdens severely diminish patients’ quality of life and incur heavy healthcare utilisation.ConclusionsSeveral countries have abundant data on HZ, but others, especially in South-East Asia, very few. However, Asia-Pacific countries generally lack data on HZ vaccine safety, efficacy and cost-effectiveness. Physicians treating HZ and its complications in Asia-Pacific face familiar challenges but, with a vast aged population, Asia bears a unique and growing burden of disease. Given the strong rationale for prevention, most adult immunisation guidelines include HZ vaccine, yet it remains underused. We urge all stakeholders to give higher priority to adult immunisation in general and HZ in particular.

【 授权许可】

CC BY   
© The Author(s). 2017