Epidemiology

Over 90% of adults in the US have serologic evidence of varicella-zoster virus (VZV) infection and are therefore at risk of HZ.[4]

The annual incidence of HZ in the UK is estimated between 1.85 and 3.9 cases per 1000 population.[5]​​ It increases with age from fewer than two cases per 1000 among people under 50 years to 11 cases per 1000 among people ages 80 years or over. HZ has no seasonal variation, and there appears to be no difference in incidence worldwide.

Incidence is higher among women.[6] The incidence is also higher in people with immunosuppression (e.g., those with HIV or malignancies, and those on chemotherapy and corticosteroid treatment).[7][8][9] The risk of shingles remains increased among people living with HIV, even if they are taking antiretroviral therapy.[6][10][11] Black people appear less likely to experience HZ than other ethnicities.[12] It is unknown if exposure to unvaccinated children offers protection.[13]

Incidence of HZ has increased over time in the US, both before and after the varicella vaccination program.[14][15] Incidence has also increased in other countries such as Canada, the UK, and Japan, where there are no varicella vaccination programs.[16][17][18]

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