{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T08:13:28Z","timestamp":1788941608681,"version":"build-2803163510"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Immunocompromised adults are at .increased risk of herpes zoster (HZ) infection and related complications. We aimed to assess the incidence of hospital-attended HZ (ie, seen in hospital or emergency department) in immunocompromised populations and compare it to immunocompetent populations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We calculated incidence rates (IRs) of hospital-attended HZ in Ontario, Canada, between 1 April 2002 and 31 August 2016 in adults \u226518 years of age categorized as immunocompromised or immunocompetent. We repeated these analyses by type of immunocompromising condition and provided incidence rate ratios (IRRs) comparing to immunocompetent adults. We also calculated IRs and IRRs of HZ complications by immunocompromised status.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 135 206 incident cases of hospital-attended HZ during the study period. Immunocompromised adults accounted for 13% of these cases despite representing 3% of the population. The risk of hospital-attended HZ was higher for immunocompromised adults compared with immunocompetent adults (IRR, 2.9 [95% confidence interval {CI}, 2.9\u20133.0]) and ranged across type of immunocompromising conditions, from 2.6 (95% CI, 2.6\u20132.7) in those with a solid tumor malignancy to 12.3 (95% CI, 11.3\u201313.2) in those who had undergone hematopoietic stem cell transplant. The risk of any HZ complication was higher in immunocompromised adults (IRR, 3.6 [95% CI, 3.5\u20133.7]) and highest for disseminated zoster (IRR, 32.8 [95% CI, 27.8\u201338.6]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The risk of hospital-attended HZ and related complications was higher in immunocompromised populations compared with immunocompetent populations. Our findings underscore the high-risk nature of this population and the potential benefits that may be realized through HZ vaccination.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciz769","type":"journal-article","created":{"date-parts":[[2019,8,20]],"date-time":"2019-08-20T19:16:07Z","timestamp":1566328567000},"page":"22-29","source":"Crossref","is-referenced-by-count":26,"title":["Incidence of Hospitalizations and Emergency Department Visits for Herpes Zoster in Immunocompromised and Immunocompetent Adults in Ontario, Canada, 2002\u20132016"],"prefix":"10.1093","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5286-8974","authenticated-orcid":false,"given":"Sarah A","family":"Buchan","sequence":"first","affiliation":[{"name":"Public Health Ontario, University of Toronto, Ontario, Canada"},{"name":"Institute for Clinical Evaluative Sciences, University of Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Daneman","sequence":"first","affiliation":[{"name":"Public Health Ontario, University of Toronto, Ontario, Canada"},{"name":"Institute for Clinical Evaluative Sciences, University of Toronto, Ontario, Canada"},{"name":"Sunnybrook Research Institute, Ontario, Canada"},{"name":"Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Ontario, Canada"},{"name":"Department of Medicine, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Wang","sequence":"first","affiliation":[{"name":"Public Health Ontario, University of Toronto, Ontario, Canada"},{"name":"Institute for Clinical Evaluative Sciences, University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Garber","sequence":"first","affiliation":[{"name":"Public Health Ontario, University of Toronto, Ontario, Canada"},{"name":"Department of Medicine, Ontario, Canada"},{"name":"Ottawa Hospital Research Institute, University of Toronto, Ontario, Canada"},{"name":"Department of Medicine, University of Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne E","family":"Wormsbecker","sequence":"first","affiliation":[{"name":"Unity Health Toronto, University of Toronto, Ontario, Canada"},{"name":"Department of Pediatrics, Faculty of Medicine, University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E","family":"Wilson","sequence":"first","affiliation":[{"name":"Public Health Ontario, University of Toronto, Ontario, Canada"},{"name":"Institute for Clinical Evaluative Sciences, University of Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley L","family":"Deeks","sequence":"first","affiliation":[{"name":"Public Health Ontario, University of Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,8,22]]},"reference":[{"key":"2020062404335730300_CIT0001","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1155\/2010\/178036","article-title":"Management and prevention of herpes zoster: a Canadian perspective","volume":"21","author":"Boivin","year":"2010","journal-title":"Can J Infect Dis Med Microbiol"},{"key":"2020062404335730300_CIT0002","doi-asserted-by":"crossref","first-page":"2266","DOI":"10.1056\/NEJMp058091","article-title":"Aging, immunity, and the varicella-zoster virus","volume":"352","author":"Arvin","year":"2005","journal-title":"N Engl J Med"},{"key":"2020062404335730300_CIT0003","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/S1473-3099(03)00857-0","article-title":"What does epidemiology tell us about risk factors for herpes zoster?","volume":"4","author":"Thomas","year":"2004","journal-title":"Lancet Infect Dis"},{"key":"2020062404335730300_CIT0004","doi-asserted-by":"crossref","first-page":"e004833","DOI":"10.1136\/bmjopen-2014-004833","article-title":"Systematic review of incidence and complications of herpes zoster: towards a global perspective","volume":"4","author":"Kawai","year":"2014","journal-title":"BMJ Open"},{"key":"2020062404335730300_CIT0005","volume-title":"Ottawa, ON: Her Majesty the Queen in Right of Canada","author":"Public Health Agency of Canada, National Advisory Committee on Immunization. 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