Herpes Zoster
Conditions
Keywords
herpes zoster, cancer, costs, postherpetic neuralgia
Brief summary
Herpes zoster (HZ) is an important infectious complication among patients with cancer, particularly in the setting of treatment-related immunosuppression. This retrospective observational cohort study aimed to characterize the clinical profile of HZ episodes and estimate direct hospital costs associated with emergency department visits and hospitalizations in patients with active malignancy treated at a Brazilian tertiary cancer center. The study also explored associations between cancer characteristics, recent oncologic therapies, and clinical outcomes, including postherpetic neuralgia, recurrence, disease dissemination, and hospital costs. Findings are intended to support future budget impact and cost-effectiveness analyses of herpes zoster vaccination in oncology populations.
Detailed description
Herpes zoster (HZ) is associated with substantial morbidity among patients with cancer because of disease-related and treatment-related immunosuppression. Beyond the acute infection, HZ may delay anticancer treatment, increase healthcare utilization, and lead to long-term complications such as postherpetic neuralgia. Despite its clinical relevance, real-world data describing the clinical burden and direct hospital costs of HZ in oncology patients in Brazil remain limited. This retrospective observational cohort study included adult patients with active cancer diagnosed with herpes zoster between September 2019 and December 2024 at A.C. Camargo Cancer Center, São Paulo, Brazil. Patients were identified through electronic medical records and institutional infection control databases. Demographic characteristics, cancer type and stage, recent oncologic therapies, clinical presentation, complications, recurrence, and postherpetic neuralgia were evaluated. Direct hospital costs related to emergency department visits and hospitalizations were obtained from institutional administrative databases. The study was designed to characterize the clinical and economic burden of herpes zoster in oncology patients and to explore associations between oncologic characteristics and clinical and economic outcomes, providing real-world evidence to support future health economic evaluations and vaccination strategies.
Interventions
OTHERHerpes Zoster episode
Clinically confirmed herpes zoster episode (initial episode or recurrence) identified through electronic medical records.
Sponsors
AC Camargo Cancer Center
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults (≥18 years). * Active solid or hematologic malignancy. * Evaluation at A.C. Camargo Cancer Center (São Paulo, Brazil) between September 2019 and December 2024. * Clinically confirmed episode of herpes zoster (initial episode or recurrence). * Herpes zoster diagnosed based on a typical painful dermatomal rash with polymorphic lesions (macules, papules, vesicles, and crusts), either localized or disseminated.
Exclusion criteria
* Age \<18 years. * No evidence of active malignancy (complete remission or no oncologic treatment for at least one year). * Patients in whom herpes zoster was not confirmed after medical record review.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Clinical characteristics of herpes zoster episodes | September 2019 through December 2024 | Characterization of herpes zoster episodes in adult patients with active cancer, including clinical presentation, dissemination, postherpetic neuralgia, recurrence, cancer type and stage, and recent oncologic therapies. |
| Direct hospital costs | September 2019 through December 2024 | Estimation of direct hospital costs associated with emergency department visits and hospitalizations related to herpes zoster in patients with active cancer. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postherpetic neuralgia | 3 months after herpes zoster episode | Occurrence of postherpetic neuralgia, defined as neuropathic pain persisting for at least 3 months after the onset of herpes zoster. |
Countries
Brazil
Outcome results
None listed