Infectious Disease
Association of Chronic Diseases with Herpes Zoster in China: A Nationwide Population-based Survey Wenhui Zhu* Wenhui Zhu Peking University
Background: The global burden of herpes zoster (HZ) is rising, posing a major public health challenge, especially among aging populations with high chronic disease prevalence. Although chronic conditions are known risk factors, population-based evidence from China remains scarce.
Objective: To examine the association between chronic diseases and HZ using nationally representative data from China, considering demographic and lifestyle factors.
Methods: We conducted a national population-based survey using the 2024 China Family Panel Survey (CFPS). A probability proportional to size sampling method was employed, covering 25 provinces and regions and representing 95% of the population in mainland China. A structured questionnaire collected data on HZ diagnosis, chronic disease status, and demographics. Incidence rates were calculated, and multivariable logistic regression was used to estimate adjusted odds ratio (aOR).
Results: Among 27868 participants (21496 adults; 6372 minors), 809 adult HZ cases were identified, with 64.40% (n=521) having at least one chronic condition. Female adults with chronic diseases had a higher incidence (12.94/1000 PY; 95% CI: 11.45-14.56) than males (8.78/1000 PY; 95% CI: 7.55-10.12). Incidence increased with age, from 8.07/1000 PY (95% CI: 4.45-13.10) in those aged 18-29 to 13.36/1000 PY (95% CI: 11.08-15.96) in those ≥70. Chronic disease was associated with elevated HZ risk (aOR=1.84; 95% CI: 1.51-2.24). Among 14 chronic conditions, heart disease showed the strongest association (aOR=2.91; 95% CI: 2.07-4.10), followed by diabetes (aOR=2.04; 95% CI: 1.48-2.80) and hypertension (aOR=1.89; 95% CI: 1.47-2.42).
Conclusions: Chronic diseases, particularly cardiovascular and metabolic conditions, are significantly associated with increased HZ risk. These findings highlight the need for targeted HZ prevention strategies, including vaccination, among high-risk groups in China.