Epidemiology of herpes zoster and post-herpetic neuralgia in China: A nationwide population-based survey

Background Herpes zoster (HZ) and post-herpetic neuralgia (PHN) cause substantial burden globally, while China lacks nationwide statistics of HZ incidence. This study aims to provide national epidemiology profile for HZ and PHN in China. Methods A nationwide population-based survey was conducted in China in 2024. We calculated the incidence of HZ and proportion of PHN among HZ patients, and identified risk factors through multivariate regression. Incidence trend, seasonality, and duration of zoster associated pain (ZAP) and rash were also analyzed. Results The study included 27868 individuals and found an adjusted annual HZ incidence of 5.85/1000 person-years, which was associated with female sex, older age, urban residency, and chronic diseases. 15.84% of them developed PHN, with females and older individuals at greater risk. The HZ incidence rose each year and increased largely after 2022. There was no seasonality trend of HZ or PHN. Around one third patients suffered from ZAP for longer than 3 months and had the rash for more than weeks. Conclusion This study establishes the first nationwide epidemiology profile of HZ in China, quantifies the proportion of PHN and identifies key risk factors including female sex, older age, urban residency, and chronic comorbidities.