{
  "abstract": "Introduction Herpes zoster (HZ) is caused by reactivation of varicella-zoster virus, which remains latent in individuals after a primary infection. Studies have shown an increased risk of HZ with age, and in patients with certain conditions, including cardiovascular conditions. However, limited robust epidemiological data are available on HZ occurrence in these populations. This study aimed to provide current epidemiological data on HZ occurrence amongst adults in England with chronic conditions, including coronary artery disease (CAD) and heart failure (HF), by age.Methods We conducted a retrospective cohort study in adults aged 18 years or older in England, using routinely collected data from the Clinical Practice Research Datalink with linkage to Hospital Episodes Statistics. Adults with a record of at least one chronic condition (asthma, CAD, chronic obstructive pulmonary disease, chronic kidney disease, chronic liver disease, depression and/or anxiety, diabetes, HF) between 01 January 2012 (study start) and 31 December 2018 were identified and followed up until 31 December 2019 (study end). A group of adults without any record of chronic (as above) or immunocompromising (IC) conditions (autoimmune disease, human immunodeficiency virus, haematological malignancies, haematopoietic stem cell transplant, solid organ transplant/malignancies) were also identified and followed up during the same period. HZ Incidence Rates (IRs) were estimated per 1,000 person-years with 95% confidence intervals (by age and condition).Results A total of 6,423,633 adults with at least one chronic condition were identified (mean [standard deviation; SD] age: 48.35 [20.03] years, 54.30% female). Of these, 6.27% (n=402,518) had a record of CAD (mean [SD] age: 70.77 [13.50] years) and 1.23% (n=79,152) of HF (mean [SD] age: 73.96 [16.43] years) ( table 1). A total of 8,235,858 adults without chronic or IC conditions were identified (mean [SD] age: 37.55 [16.06], 52.73% male) (table 1). HZ IRs increased with age in all populations, and were higher in adults with CAD or HF than adults in the same age group without any chronic or IC conditions of interest reported (table 2 and figure 1). For example, the HZ IR in adults aged 18–49 years with CAD or HF was 2.34 (2.02–2.70) and 2.41 (1.79–3.16), respectively, compared to 1.43 (1.41–1.44) in adults without chronic or IC conditions. The HZ IR in adults aged 80 years or older with CAD or HF was 11.80 (11.49–12.11) and 11.54 (10.85–12.27), respectively, compared to 8.57 (8.33–8.81) in adults without chronic or IC conditions (table 2).Conclusions This large and current study suggests that HZ affects adults with CAD and HF more often than adults in the same age group without chronic or IC conditions of interest. Researchers and decision makers within the UK and worldwide could use this knowledge to inform further HZ research in people with cardiovascular conditions, clinical guidelines and immunisation recommendations.Funding GSK (VEO-000562).Abstract 5-019 Table 1Baseline characteristics of adults with at least one chronic condition, adults with coronary artery disease or heart failure, and adults without chronic or immunocompromising conditions (CPRD-HES, 2012–2019) Characteristics Adults with at least one chronic condition (n=6,423,633)* Adults with Coronary Artery Disease (n= 402,518 ) Adults with Heart Failure (n= 79,152 ) Adults without chronic or immunocompromising conditions (n=8,235,858)** Male, n (%) 2,935,397 (45.70%) 265,278 (65.90%) 42,809 (54.08%) 4,342,779 (52.73%) Female, n (%) 3,488,236 (54.30%) 137,240 (34.10%) 36,343 (45.92%) 3,893,079(47.27%) Mean (SD) age (years) at index date*** 48.35(20.03) 70.77 (13.50) 73.96(16.43) 37.55(16.06) 18–49 years at index date***, n (%) 3,562,279 (55.46%) 28,169(7.00%) 7,122(9.00%) 6,468,194(78.54%) 50–59 years at index date***, n (%) 936,607 (14.58%) 57,092(14.18%) 7,782(9.83%) 859,970(10.44%) 60–64 years at index date***, n (%) 437,108 (6.80%) 44,567(11.07%) 5,701(7.20%) 315,190(3.83%) 65–69 years at index date***, n (%) 409,646 (6.38%) 54,906(13.64%) 7,482(9.45%) 236,392(2.87%) 70–79 years at index date***, n (%) 589,487 (9.18%) 107,265 (26.65%) 16,713 (21.12%) 236,776(2.87%) ≥80 years at index date***, n (%) 488,506 (7.60%) 110,519 (27.46%) 34,352 (43.40%) 119,336(1.45%) Abbreviations. CPRD: Clinical Practice Research Datalink. HES: Hospital Episode Statistics. n: number of patients. SD: Standard deviation.*Adults with a CPRD or HES record of any chronic conditions of interest (asthma, coronary artery disease, chronic obstructive pulmonary disease, chronic kidney disease, chronic liver disease, depression and/or anxiety, diabetes, heart failure).**Adults without a CPRD or HES record of any chronic conditions of interest (asthma, coronary artery disease, chronic obstructive pulmonary disease, chronic kidney disease, chronic liver disease, depression and/or anxiety, diabetes, heart failure) and without any immunocompromising condition of interest (autoimmune disease, human immunodeficiency virus, haematological malignancies, haematopoietic stem cell transplant, solid organ transplant/malignancies).***Index date is the latest of the following dates: study start date (01 January 2012), date of patient’s 18th birthday, date of registration with a General Practitioner’s practice. For adults with at least one chronic condition of interest, the index date also includes the diagnosis date of the first chronic condition. If patients had a record of both coronary artery disease and heart failure on their index date, they would be included in both groups. However, if the patient had records of both conditions but on different dates, patients were only captured within the first condition group.Abstract 5-019 Table 2Incidence rates of herpes zoster in adults with at least one chronic condition, adults with coronary artery disease or heart failure, and adults without chronic or immunocompromising conditions (CPRD-HES, 2012–2019), overall by age Age (years) HZ Incidence Rates per 1000 Person Years (95% Confidence Interval) Adults with at least one chronic condition (n=6,423,633)* Adults with Coronary Artery Disease (n= 402,518 ) Adults with Heart Failure (n= 79,152) Adults without chronic or immunocompromising conditions (n=8,235,858)** 18–49 2.45(2.42–2.48) 2.34(2.02–2.70) 2.41(1.79–3.16) 1.43(1.41–1.44) 50–59 4.92(4.86–4.98) 4.23(3.96–4.51) 4.66(3.86–5.56) 3.26(3.21–3.31) 60–64 6.67(6.56–6.77) 6.16(5.80–6.53) 6.40(5.31–7.62) 4.84(4.73–4.94) 65–69 7.59(7.48–7.70) 6.97(6.64–7.30) 6.56(5.61–7.60) 5.69(5.57–5.81) 70–79 10.40(10.28–10.52) 10.19(9.89–10.49) 9.82(8.96–10.72) 7.76(7.60–7.92) ≥80 11.54(11.40–11.68) 11.80(11.49–12.11) 11.54(10.85–12.27) 8.57(8.33–8.81) Overall HZ IR 5.16 (5.14 - 5.19) 8.56 (8.42 - 8.70) 8.60 (8.23 - 8.99) 2.47 (2.45 - 2.49) Abbreviations: CPRD: Clinical Practice Research Datalink; HES: Hospital Episode Statistics; HZ: Herpes Zoster; IR: Incidence Rate; n: number of adults.*Adults with a CPRD or HES record of any chronic conditions of interest (asthma, coronary artery disease, chronic obstructive pulmonary disease, chronic kidney disease, chronic liver disease, depression and/or anxiety, diabetes, heart failure).**Adults without a CPRD or HES record of any chronic conditions of interest (asthma, coronary artery disease, chronic obstructive pulmonary disease, chronic kidney disease, chronic liver disease, depression and/or anxiety, diabetes, heart failure) and without a CPRD or HES record of any immunocompromising condition of interest (autoimmune disease, human immunodeficiency virus, haematological malignancies, haematopoietic stem cell transplant, solid organ transplant/malignancies).Abstract 5-019 Figure 1Incidence rates of herpes zoster in adults with at least one chronic condition, adults with coronary artery disease or heart failure, and adults without chronic or immunocompromising conditions (CPRD-HES, 2012–2019), by age. Abbreviations. CAD: coronary artery disease, HF: heart failure, IC: immunocompromising. ‘any chronic’ refers to adults with a CPRD or hes record of any chronic conditions of interest (asthma, coronary artery disease, chronic obstructive pulmonary disease, chronic kidney disease, chronic liver disease, depression and/or anxiety, diabetes, heart failure)‘Non-chronic & non-IC’ refers to adults without a CPRD or HES record of any chronic conditions of interest (asthma, coronary artery disease, chronic obstructive pulmonary disease, chronic kidney disease, chronic liver disease, depression and/or anxiety, diabetes, heart failure) and without a CPRD or HES record of any immunocompromising condition of interest (autoimmune disease, human immunodeficiency virus, haematological malignancies, haematopoietic stem cell transplant, solid organ transplant/malignancies).Conflicts of Interest AbM, MN, YV, DO, CO, IP, SF, BG, AlM are GSK employees. AbM declares being a member of the board of trustees for a mental health charity, Beyond Conflict (registered charity number: 1176499) – voluntary (unpaid). MH was a GSK employee during study conception, design and execution. MN, DO, AlM hold financial equities in GSK. YV, MH, IP hold financial equities in GSK and Haleon. CO holds financial equities in GSK and Pfizer. SF holds financial equities in GSK, Sanofi, and Organon. BG holds financial equities in GSK and MSD. KK, BCP, SP, SS, LR, SL-F, VS are IQVIA Ltd. employees. IQVIA received financial compensation from GSK for protocol development, analysis and conduct of the present study. These authors declare no other financial and non-financial relationships and activities.Acknowledgments The authors thank Saskia Hagenaars (IQVIA Ltd, London, UK) for her epidemiological contribution to the protocol development and results interpretation. They also thank Dr. Helen Parry (University Hospitals Birmingham NHS Foundation Trust (UHB) - Queen Elizabeth Hospital Birmingham (Haematology Service), Birmingham, UK) for her clinical contribution to protocol development and results interpretation. Enovalife Medical Communication Service Center provided editorial assistance and publication coordination, on behalf of GSK.Congress-specific disclosures The data reported in the current abstract are part of a large study on the occurrence of Herpes Zoster in adults in England with various immunocompromising or chronic conditions: Burden of Disease of Herpes Zoster among adults aged 18 years old and older at increased risk due to an immunocompromising or chronic condition in England: a retrospective cohort study | CPRD. Study data on Herpes Zoster occurrence in adults with immunocompromising conditions have been accepted for poster presentation in April 2025 at the Congress of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID Global, 2025) in Vienna, Austria. Granular study data on Herpes Zoster occurrence in adults with haematological malignancies have been accepted for poster presentation in April 2025 at the British Society of Haematology 2025 in Glasgow, Scotland. The data presented in the current abstract have not been accepted for publication elsewhere, nor will they be presented at ESCMID 2025 or BSH 2025, or presented at any conference before the BCS conference in June 2025. Some of the data presented in the current abstract have been submitted for poster presentation to the Royal College of General Practitioner (RCGPs) 2025 (which will be held in October 2025), as part of a general abstract on Herpes Zoster in adults with chronic conditions.",
  "authors": [
    {
      "affiliations": [
        "GSK, Wavre, Belgium"
      ],
      "name": "Abda Mahmood"
    },
    {
      "affiliations": [
        "GSK, Rueil Malmaison, France"
      ],
      "name": "Marie Nishimwe"
    },
    {
      "affiliations": [
        "GSK, London, UK"
      ],
      "name": "Yasmeeta Vekria"
    },
    {
      "affiliations": [
        "GSK, London, UK"
      ],
      "name": "Manjit Hunjan"
    },
    {
      "affiliations": [
        "IQVIA Ltd, London, UK"
      ],
      "name": "Karabo Keapoletswe"
    },
    {
      "affiliations": [
        "IQVIA Ltd, London, UK"
      ],
      "name": "Sarah Lay-Flurrie"
    },
    {
      "affiliations": [
        "GSK, London, UK"
      ],
      "name": "Claire O’Reilly"
    },
    {
      "affiliations": [
        "GSK, Rockville, USA"
      ],
      "name": "Driss Oraichi"
    },
    {
      "affiliations": [
        "GSK, Rockville, USA"
      ],
      "name": "Spyros Paparrodopoulos"
    },
    {
      "affiliations": [
        "IQVIA Ltd, Sofia, Bulgaria"
      ],
      "name": "Simeon Stavrev"
    },
    {
      "affiliations": [
        "IQVIA Ltd, London, UK"
      ],
      "name": "Louise Raiteri"
    },
    {
      "affiliations": [
        "IQVIA Ltd, London, UK"
      ],
      "name": "Bhagya Chengat"
    },
    {
      "affiliations": [
        "GSK, Wavre, Belgium"
      ],
      "name": "Inga Posiuniene"
    },
    {
      "affiliations": [
        "GSK, London, UK"
      ],
      "name": "Susan Farrow"
    },
    {
      "affiliations": [
        "GSK, London, UK"
      ],
      "name": "Boriana Guimicheva"
    },
    {
      "affiliations": [
        "IQVIA Ltd, London, UK"
      ],
      "name": "Valeria Sanglimbene"
    },
    {
      "affiliations": [
        "GSK, Munich, Germany"
      ],
      "name": "Alen Marijam"
    }
  ],
  "title": "5-019 Herpes zoster incidence rates in adults aged 18 years or older with coronary artery disease or heart failure in England: a retrospective cohort study using data from the clinical practice research datalink (2012–2019)",
  "uid": "7932555e-fa33-5a60-af11-1f4c34b6e8ae"
}