A systematic review and meta-analysis of herpes zoster risk in adults with immunocompromised conditions and autoimmune diseases in Asia-Pacific

Asia-Pacific (APAC) faces an increasing burden of herpes zoster (HZ) over time. The risk of HZ and its complications are increased in immunocompromised (IC) patients and those with autoimmune diseases (AID). Our study aimed to synthesize evidence on the epidemiological burden of HZ and its complications among the general adult population and patients with IC/AID conditions in APAC. Following a systematic literature review, we performed meta-analyses for outcomes where ≥3 studies met the inclusion criteria. Of the 271 articles identified, 75 were included for meta-analysis. We found a high burden of HZ and its complications (i.e., postherpetic neuralgia, HZ ophthalmicus), particularly among individuals with IC/AID conditions in APAC. Patients with IC/AID conditions had significantly increased HZ risk and a higher proportion of HZ recurrence than the general adult population. These findings may inform clinical practice and public health decisions regarding HZ prevention, including HZ vaccination strategies, among the IC/AID population in APAC.