Herpes zoster: burden of disease and current prevention strategies in Spain

Abstract

Herpes zoster, as we all know, is produced by the Varicella-Zoster Virus and appears after the reactivation of the virus due to a situation of immunosuppression, either due to an illness or after 60 years of age, related to the phenomenon of immunosenescence, This happens when that person has suffered a primary infection that produces chickenpox, given that subsequently, this virus has the capacity to remain in the dorsal ganglia of the spinal cord or cranial pairs for long periods of time and reactivate in the aforementioned situations producing a lesion that we call herpes zoster. Although it can occur in any age group, the main triggering factor is the decrease in immunity measured by cells associated with natural immunosenescence due to aging and/or immunosuppression due to oncological and chronic pathologies and/or immunosuppressive drug treatments. It is estimated that up to 30% of the population will develop a clinical picture of herpes zoster during their lifetime. It is known that the burden of disease caused by herpes zoster in the population >50 years of age is so high that it would justify routine vaccination of the population. These patients have a higher risk of reactivation of the virus, higher probability of PHN, higher risk of hospitalization and worse quality of life, especially in immunocompromised patients and in those over 60-65 years of age. This burden of disease represents a high health expenditure and consumption of resources. It is therefore necessary to support the vaccination strategies implemented by the health authorities and to implement systematic vaccination, at least in >65 years of age, as the population group at greatest risk, as the main preventive measure to avoid the appearance of cases requiring hospitalization.