Background: �The causes for herpes zoster (HZ) are largely unknown.� Older age and diminished cell mediated immunity are well-documented risk factors but cannot explain by themselves the epidemiology of HZ.� Several other factors have been evaluated but are unconfirmed or of insufficient prevalence to explain most episodes.� During a community-based study, we assessed potential HZ risk factors for which data cannot be obtained from medical records. Factors associated with increased risk of zoster included rheumatoid arthritis (3111 (2.1%) v 8029 (1.5%); adjusted odds ratio 1.46, 99% confidence interval 1.38 to 1.55), inflammatory bowel disease (1851 (1.3%) v 5118 (0.9%); 1.36, 1.26 to 1.46), chronic obstructive pulmonary disease (6815 (4.7%) v 20 201 (3.7%); 1.32, 1.27 to 1.37), asthma (10 243 (7.1%) v 31 865 (5.8%); 1.21, 1.17 to 1.25), chronic kidney disease (8724 (6.0%) v 29 437 (5.4%); 1.14, 1.09 to 1.18), and depression (6830 (4.7%) v 22 052 (4.0%); 1.15, 1.10 to 1.20). Results: Of 119,413 zoster patients, 6,956 (5.8%) developed postherpetic neuralgia. We registered gender and HZ occurrence, as well as other risk factors for HZ. Dissemination occurred in 6 episodes (11%), and was more frequent during immunosuppressive therapy [odds ratio (OR) = 4.0]. Control variables included age, sex, education, cancer, other chronic diseases, hospitalization, activities of daily living, self-rated health, depression, and cigarette smoking. All the participants in the study gave informed consent and were interviewed by medically trained and blinded investigators using a questionnaire.
However, the epidemiology of herpes zoster in nonwhite populations and potential racial differences have not been well studied. Furthermore, high CMV IgG titers (exceeding the upper threshold) were less abundant in CMV-seropositive Belgian N2 population samples than in CMV-seropositive UK HZ patients (OR 0.51 [0.31 0.82]. As zoster vaccination is contraindicated for patients with severe immunosuppression, strategies to prevent zoster in these patients, which could include the new subunit zoster vaccine, are an increasing priority.