Ocular Microbiology and Immunology Group
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2019 OMIG Abstract

Incidence Rate of Herpes Zoster Ophthalmicus (HZO): A Retrospective Cohort Study from 1994 to 2018

Christina Kong, BS, Ryan Thompson, MSPH, Travis Porco, PhD, MPH, Eric Kim, MA,
Nisha Acharya, MD, MS
F.I. Proctor Foundation, University of California, San Francisco, San Francisco, CA;
OptumLabs Visiting Fellow, Cambridge MA

Methods: OptumLabs® Data Warehouse (OLDW), a longitudinal, real-world data asset with de-identified administrative claims and clinical information, was used to identify cases of HZO during the study period. Enrollees with continuous enrollment for =365 days and with no known history of herpes zoster (HZ) or HZO were included. Patients with a new code for HZ (ICD-9 053.XX; ICD-10 B02.XX) and HZO (ICD-9 0532.X; ICD-10 B023.X) were counted as incident cases. The incidence rate of HZO was calculated yearly and by 5-year age groups for subanalyses by sex, race/ethnicity, and geographic region. Incidence rates were compared using the chi-square test.

Results: From 1994 to 2018, 633,474 cases of HZ were reported with 49,711 (7.9%) having HZO. The incidence of HZO increased from 1994 to 2018 by an estimated 1.1 cases per 100,000 person-years annually (95% CI 1.03 to 1.31, P<0.001) and an estimated relative increase of 3.6% per year (95% CI 3.0% to 4.1%). Overall, the HZO incidence rate increased in all age groups from 1994 to 2009 (linear model; P<0.001). From 2010 and later, the HZO incidence rate declined among individuals less than 30 years old (P<0.001) and those over 60 years old (P<0.001). There was no evidence of change in HZO incidence rates among 31 to 60-year-old individuals from 2010 onwards (P=0.86). Women had a higher HZO incidence rate ratio (IRR) of 1.4 compared to men (P<0.001). Caucasians had IRRs of 1.5 compared to Asians,1.6 compared to Hispanics, and 1.3 compared to African Americans (P<0.001). IRR was 1.3 in the Northeast compared to the Midwest, 1.3 compared to the South, and 1.5 compared to the West (P<0.001).

Conclusion: The incidence of HZO has increased from 1994 to 2018 in the US population. Since 2010, HZO incidence has declined in individuals younger than 30 and older than 60 but does not show significant change between 31 and 60 years of age. Given the changing epidemiology, it may be prudent for health policy makers to revisit recommendations regarding age of HZ vaccination.

Disclosure: S: 1R01 EY028739-01, 5R01 EY028739-02, OptumLabs Warehouse research credit

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