Clinical and Economic Impact of Herpes Zoster in Cancer Patients

Overview

Herpes zoster (HZ) is an important infectious complication among patients with cancer, particularly in the setting of treatment-related immunosuppression. This retrospective observational cohort study aimed to characterize the clinical profile of HZ episodes and estimate direct hospital costs associated with emergency department visits and hospitalizations in patients with active malignancy treated at a Brazilian tertiary cancer center. The study also explored associations between cancer characteristics, recent oncologic therapies, and clinical outcomes, including postherpetic neuralgia, recurrence, disease dissemination, and hospital costs. Findings are intended to support future budget impact and cost-effectiveness analyses of herpes zoster vaccination in oncology populations.

Herpes zoster (HZ) is associated with substantial morbidity among patients with cancer because of disease-related and treatment-related immunosuppression. Beyond the acute infection, HZ may delay anticancer treatment, increase healthcare utilization, and lead to long-term complications such as postherpetic neuralgia. Despite its clinical relevance, real-world data describing the clinical burden and direct hospital costs of HZ in oncology patients in Brazil remain limited. This retrospective observational cohort study included adult patients with active cancer diagnosed with herpes zoster between September 2019 and December 2024 at A.C. Camargo Cancer Center, São Paulo, Brazil. Patients were identified through electronic medical records and institutional infection control databases. Demographic characteristics, cancer type and stage, recent oncologic therapies, clinical presentation, complications, recurrence, and postherpetic neuralgia were evaluated. Direct hospital costs related to emergency department visits and hospitalizations were obtained from institutional administrative databases. The study was designed to characterize the clinical and economic burden of herpes zoster in oncology patients and to explore associations between oncologic characteristics and clinical and economic outcomes, providing real-world evidence to support future health economic evaluations and vaccination strategies.

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