A Population-Based Study on the Burden of Herpes Zoster and Post-Herpectic Neuralgia
Bibliographic record
Abstract
Background. Reactivation of the varicella zoster virus later in life is known as herpes zoster (HZ) infection or shingles. Recent studies have shown increasing incidence of HZ infection, which may be related to the introduction of the varicella vaccination program in children. We looked at the epidemiology of HZ and its complications, including post-herpetic neuralgia (PHN) over time. Methods. The cohort, obtained from PopulationDataBC, was all cases with HZ infection from 1 January 1997 and 31 December 2012. Incident zoster was defined as a case with an ICD-9 code of 053 or ICD-10 code of B02 without a previous episode of HZ or PHN in the previous 12 months. PHN was identified as those with a first episode of HZ with a further zoster diagnostic code after 90 d with a relevant prescription for analgesia, anticonvulsant, or antidepressant therapy on the same day as the recorded consultation. Age-sex standardized rate for the overall population was calculated using the 2006 Canadian census. Incidence for HZ and PHN was determined by identifying the number of events per 1000 population. We determined the association between the varicella vaccination program and increased HZ rates by evaluating the rate ratios in the publicly-funded varicella vaccine period compared to the pre-licensure and privately-available periods and through a regression model. Results. HZ incidence increased for the entire study period from 3.2 per 1000 population in 1997 to 4.5 in 2012. HZ rates were higher for females than males and for all age groups, except the 0-9 year olds, where the rate decreased. All regions of British Columbia followed the same pattern and increase. Crude and age-sex standardized incidence rate of PHN demonstrated very similar patterns of HZ incidence. Based on the regression model, rates of HZ were higher in the older individuals, females, and those who were immunocompromised. We will explore if an increase with HZ incidence is seen during the publically funded varicella vaccination program compared to the pre-licensure and privately funded periods. Conclusion. The incidence of zoster and PHN is increasing with time, particularly in the elderly population and the risk is greater in over 65 years, females and those immunocompromised. Disclosures. F. Marra, Merck Canada Inc: Grant Investigator, Research grant.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".