The Characteristics of Hospitalized Patients with Herpes Zoster Over the Years

Abstract

Introduction: Herpes Zoster (HZ) represents a significant health burden, most commonly affecting elderly and immunocompromised patients. In the recent years, increasing rates of HZ-related hospitalizations have been reported worldwide, particularly among patients with predisposing risk factors.

Objective: The objectives of the study aims were to estimate the hospitalization rates in Israel, to characterize the patients' clinical profile, as well as their disease course and prognosis.

Methods: A retrospective cohort study, using data from electronic medical records of patients hospitalized with HZ at Clalit Health Services' seven hospitals from January 2002 to December 2024. The data was evaluated for: the annual rate of hospitalizations, patients' demographic and the clinical characteristics, hospitalization course, complications and outcome.

Results: The cohort included 3,907 patients (mean age 68 ± 18 years; 52% women). Hospitalization rates ranged from 1.54 to 2.67 per 100,000, peaking in 2018 (n=237 per year) and declining thereafter. The majority of hospitalizations (57%) were at the two tertiary care centers. Common comorbidities included immunosuppressive therapy (49%), malignancy (43%), diabetes mellitus (39%) and organ transplant recipients (8%). Antiviral treatment by Acyclovir was administered in 96% of the cases, primarily intravenously (50%), for a mean of 6 ± 4 days. Complications occurred in 20%, most frequently post-herpetic neuralgia (7%). The 30-days mortality rate was 2% and re-hospitalization due to recurrence occurred in 0.84%.

Conclusions: HZ-related hospitalization rates fluctuated but showed no consistent upward trend throughout the study period. Several risk factors were identified, emphasizing early prevention through vaccination to reduce disease burden and complications.