Postherpetic Neuralgia Occurrence and Herpes Zoster Recurrence in Immunocompromised Adults Aged 18 Years or Older in England: A Large Retrospective Cohort Study (Clinical Practice Research Datalink 2012-2019)
Author(s)
Abda Mahmood, BSc (Hons), MSc, PhD1, Marie Libérée Nishimwe, MSc2, Yasmeeta Vekria, BSc. (HONS)3, Driss Oraichi, Dr/PhD4, Manjit Hunjan, Dr3, Saskia Hagenaars, Dr/PhD5, Karabo Keapoletswe, MSc6, Bhagyalakshmi Chengat Prakashbabu, Dr/PhD6, Spyros Paparrodopoulos, PhD7, Simeon Stavrev, MSc8, Sarah Lay-Flurrie, BSc (Hons), MSc, DPhil6, Claire O'Reilly, Ms/MPharm3, Louise Raiteri, MSc6, Inga Posiuniene, Dr/MD1, Susan Farrow, Dr/MD3, Boriana Guimicheva, Dr/MDRes3, Alen Marijam, PharmD9.
1GSK, Wavre, Belgium, 2GSK, Rueil-Malmaison, France, 3GSK, London, United Kingdom, 4GSK, Rockville, MD, USA, 5IQVIA, Amsterdam, Netherlands, 6IQVIA, London, United Kingdom, 7IQVIA, Athens, Greece, 8IQVIA, Sofia, Bulgaria, 9GSK, Munich, Germany.
1GSK, Wavre, Belgium, 2GSK, Rueil-Malmaison, France, 3GSK, London, United Kingdom, 4GSK, Rockville, MD, USA, 5IQVIA, Amsterdam, Netherlands, 6IQVIA, London, United Kingdom, 7IQVIA, Athens, Greece, 8IQVIA, Sofia, Bulgaria, 9GSK, Munich, Germany.
OBJECTIVES: This study aims to provide robust, current data on post-herpetic neuralgia (PHN) occurrence and herpes zoster (HZ) recurrence in immunocompromised (IC) adults.
METHODS: This retrospective cohort study analysed data from the United Kingdom Clinical Practice Research Datalink (CPRD) with linkage to Hospital Episode Statistics (HES) data and Office for National Statistics data. Adults aged ≥18 years with a record of any of the following immunocompromising conditions and active registration in CPRD Aurum between 2012-2018 were followed until 31 December 2019: haematological malignancies, haematopoietic stem cell transplantation, solid organ transplant/malignancies, human immunodeficiency virus, and autoimmune diseases. Adults without these conditions (IC-free) were identified and followed during the same period. The proportion of IC and IC-free adults who had PHN reported within 365 days following HZ diagnosis were described by age. HZ recurrence rates were estimated per 1,000 person-years (PYs) with 95% confidence intervals (CI), by age.
RESULTS: 54,574 IC (3.09%) and 182,707 IC-free (1.42%) adults developed HZ from 1,764,900 IC adults and 12,867,750 IC-free adults, respectively. In all age groups, a higher percentage of IC adults with incident HZ had PHN reported compared to IC-free adults. For example, in those aged 18-49 years with HZ, PHN was reported in 18.89% (95%CI: 17.93-19.89) of IC adults and 14.09% (95%CI: 13.78-14.40) of IC-free adults. Furthermore, in those aged 80 years and older with HZ, PHN was reported in 37.30% (95% CI: 36.21-38.39) of IC adults and 34.96% (95% CI: 34.18-35.75) of IC-free adults. In every age group, IC adults had a higher HZ recurrence rate compared to IC-free adults (e.g., 18-49 years: 31.58 [95% CI: 29.25-34.02] vs. 23.43 [95% CI: 22.70-24.17], respectively).
CONCLUSIONS: This large real-world study highlights that recurring HZ and HZ related complications are common in IC adults. These findings could be used to advance HZ research, guidelines and immunisation recommendations.
METHODS: This retrospective cohort study analysed data from the United Kingdom Clinical Practice Research Datalink (CPRD) with linkage to Hospital Episode Statistics (HES) data and Office for National Statistics data. Adults aged ≥18 years with a record of any of the following immunocompromising conditions and active registration in CPRD Aurum between 2012-2018 were followed until 31 December 2019: haematological malignancies, haematopoietic stem cell transplantation, solid organ transplant/malignancies, human immunodeficiency virus, and autoimmune diseases. Adults without these conditions (IC-free) were identified and followed during the same period. The proportion of IC and IC-free adults who had PHN reported within 365 days following HZ diagnosis were described by age. HZ recurrence rates were estimated per 1,000 person-years (PYs) with 95% confidence intervals (CI), by age.
RESULTS: 54,574 IC (3.09%) and 182,707 IC-free (1.42%) adults developed HZ from 1,764,900 IC adults and 12,867,750 IC-free adults, respectively. In all age groups, a higher percentage of IC adults with incident HZ had PHN reported compared to IC-free adults. For example, in those aged 18-49 years with HZ, PHN was reported in 18.89% (95%CI: 17.93-19.89) of IC adults and 14.09% (95%CI: 13.78-14.40) of IC-free adults. Furthermore, in those aged 80 years and older with HZ, PHN was reported in 37.30% (95% CI: 36.21-38.39) of IC adults and 34.96% (95% CI: 34.18-35.75) of IC-free adults. In every age group, IC adults had a higher HZ recurrence rate compared to IC-free adults (e.g., 18-49 years: 31.58 [95% CI: 29.25-34.02] vs. 23.43 [95% CI: 22.70-24.17], respectively).
CONCLUSIONS: This large real-world study highlights that recurring HZ and HZ related complications are common in IC adults. These findings could be used to advance HZ research, guidelines and immunisation recommendations.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH183
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
Vaccines