Association of Chronic Diseases With Herpes Zoster in China: A Nationwide Population‐Based Survey

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Background: The global burden of herpes zoster (HZ) is rising, posing a major public health challenge, especially among aging populations with high chronic disease prevalence. Although chronic conditions are known risk factors, population-based evidence from China remains scarce. Objective: The aim of the study is to examine the association between chronic diseases and HZ using nationally representative data from China, considering demographic and lifestyle factors. Methods: We conducted a national population-based survey using data from the 2024 China Family Panel Survey. A probability proportional to size sampling method was employed, covering 25 provincial-level administrative divisions and representing 95% of the population in Chinese mainland. A structured questionnaire collected data on HZ diagnosis, chronic disease status, and demographics. Incidence rates were calculated, and multivariable logistic regression was used to estimate adjusted odds ratio (aOR). Results: = 521) having at least one chronic condition. Female adults with chronic diseases had a higher incidence (12.94/1000 person-years [PY]; 95% confidence intervals [CI]: 11.45-14.56) than males (8.78/1000 PY; 95% CI: 7.55-10.12). Incidence increased with age, from 8.07/1000 PY (95% CI: 4.45-13.10) in those aged 18-29 to 13.36/1000 PY (95% CI: 11.08-15.96) in those ≥ 70. Chronic disease was associated with elevated HZ risk (aOR = 1.84; 95% CI: 1.51-2.24). Among 14 chronic conditions, heart disease showed the strongest association (aOR = 2.91; 95% CI: 2.07-4.10), followed by diabetes (aOR = 2.04; 95% CI: 1.48-2.80) and hypertension (aOR = 1.89; 95% CI: 1.47-2.42). Conclusions: Chronic diseases, particularly cardiovascular and metabolic conditions, are significantly associated with increased HZ risk. These findings highlight the need for targeted HZ prevention strategies, including vaccination, among high-risk groups in China.

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