title: The sequelae of herpes zoster.
abstract: BACKGROUND
  The last 40 years was a period during which the incidence of herpes zoster appears to have increased substantially.
  
  
  OBJECTIVE
  To determine whether the risk of complications of herpes zoster has changed during the last 40 years.
  
  
  METHODS
  The automated medical records of a health maintenance organization were screened for diagnosis codes suggesting herpes zoster and potentially complicated cases of zoster. The predictive value of a herpes zoster diagnosis was calculated from sampling full-text records. Records of all patients with codes suggesting complications were reviewed in full.
  
  
  RESULTS
  Of 859 individuals with herpes zoster who met the eligibility criteria, 101 were identified who experienced at least 1 complication, corresponding to a 60-day risk of 12%. Corrected for the sensitivity of the complication-finding strategy, the risk estimate was 14%. Risk increased markedly with age, with those older than 64 years having more than 6 times the risk of complications of those younger than 25 years (odds ratio, 8.3; 95% confidence interval, 2.5-29.3). Trigeminal distribution of rash and the presence of certain conditions associated with immune compromise appeared to increase risk.
  
  
  CONCLUSIONS
  The apparent increase in the incidence of herpes zoster was not accompanied by a change in the risk of specific or overall complications in a population-based sample. Advanced age and other conditions associated with waning cellular immunity may confer an increased risk of experiencing a complicated course of herpes zoster.
authors.affiliation: Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, Mass, USA.
authors.forename: K
authors.initials: K
authors.lastname: Galil
authors.forename: P W
authors.initials: PW
authors.lastname: Choo
authors.forename: J G
authors.initials: JG
authors.lastname: Donahue
authors.forename: R
authors.initials: R
authors.lastname: Platt
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006279:Health Maintenance Organizations; D006562:Herpes Zoster / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009437:Neuralgia / Q000453:epidemiology / Q000821:virology*; D011237:Predictive Value of Tests; D012307:Risk Factors; D012494:Sampling Studies; D012680:Sensitivity and Specificity