Open Access Research article

Epidemiology and cost of herpes zoster and postherpetic neuralgia among patients treated in primary care centres in the valencian community of Spain

Ana M Cebrián-Cuenca1, Javier Díez-Domingo2*, María San-Martín-Rodríguez3, Joan Puig-Barberá2, Jorge Navarro-Pérez4 and the Herpes Zoster Research Group of the Valencian Community

Author Affiliations

1 Centro de Salud de Ayora, Avenida Argentina, Ayora, Valencia, Spain

2 Centro Superior de Investigaciones en Salud Pública de Valencia (CSISP), Avenida Cataluña 21, 46020 Valencia, Spain

3 Departamento Médico Sanofi Pasteur MSD, Paseo de la Castellana 141, Madrid, Spain

4 CIBER Epidemiology and Public Health (CIBERESP), Spain, Calle Poeta Durán y Tortajada 7-55, 46022 Valencia, Spain

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BMC Infectious Diseases 2011, 11:302  doi:10.1186/1471-2334-11-302

Published: 1 November 2011



Data on the epidemiology and costs related to herpes zoster (HZ) and postherpetic neuralgia (PHN) in Spain are scarce; therefore, studies are needed to evaluate the epidemiological and economic impact of HZ and its most common complication, PHN. The present study aimed to estimate the clinical and economic burden of HZ and PHN in Valencia (Spain).


We prospectively analyzed the burden of HZ and PHN and their attributable costs in patients from 25 general practices in the Autonomous Community of Valencia serving 36,030 persons aged > 14 years. All patients with a clinical diagnosis of HZ who attended these centers between December 1st 2006 and November 30th 2007 were asked to participate. Patients included were followed for 1 year.


Of the 130 cases of HZ followed up, continued pain was experienced by 47.6% (95% confidence interval (CI) = 35.6-56.7%) at 1 month after rash onset, by 14.5% (95% CI = 7.8-1.2%) at 3 months, by 9.0% (95% CI = 3.7-14.3%) at 6 months, and by 5.9% (95% CI = 1.5-10.3%) at 12 months. The percentage of patients with PHN increased with age, from 21.4% (95% CI = 8.3-40) in patients < 50 years to 59.2% (95% CI = 44.4-74) in patients ≥ 70 years. The estimated total cost for the 130 HZ cases during the follow-up period was €49,160 ($67,349). Mean cost per patient was €378 (range 53-2,830) ($517, range 73-3,877).


This study shows that PHN is a relatively common complication of HZ and that both conditions combined give rise to a significant clinical and economic burden for patients and providers.