Disease burden and health-related quality of life among adults aged 50 years or older with herpes zoster in Huzhou, China

BackgroundThis study assessed the disease burden and health-related quality of life (HRQoL) among adults aged 50 years and older with herpes zoster (HZ) in Huzhou, China, and identified factors associated with increased disease burden.MethodsA cross-sectional study was conducted among adults aged 50 years or older who developed HZ between 1 June 2024 and 1 June 2025 in Huzhou, China. Participants completed a structured questionnaire in September 2025 after the acute phase and retrospectively reported HRQoL during the acute HZ phase; participants with PHN also reported HRQoL during the PHN phase. Disease-burden and HRQoL distributions were compared using the Mann–Whitney U test or Kruskal–Wallis test, as appropriate. Gamma generalized linear models (GLMs) with a log link were used to identify factors associated with total, direct, and indirect burden.ResultsA total of 222 participants were included, of whom 62 (27.9%) developed PHN. Costs were recorded in RMB as gross disease-related expenditures before reimbursement and converted using USD = RMB/7.1. The median direct burden was RMB 39,998.58 (P25, P75: RMB 11,792.27, 277,962.43), equivalent to USD 5,633.62 (P25, P75: USD 1,660.88, 39,149.64), and the median indirect burden was RMB 1,843.59 (USD 259.66; P25, P75: USD 155.79, 519.31). Participants with PHN had a higher median total burden than those without PHN (USD 10,958.43 vs. USD 4,740.60; p < 0.001). During the acute HZ phase, the median EQ-5D-5L utility and EQ-VAS scores were 0.40 (P25, P75: −0.03, 0.53) and 10.00 (P25, P75: 10.00, 10.00), respectively. Treatment setting, PHN status, and age were associated with disease burden.ConclusionHerpes zoster was associated with substantial disease burden and markedly impaired HRQoL among adults aged 50 years or older in Huzhou. PHN and inpatient treatment identified subgroups with particularly high burden. These regional estimates may inform prevention policy and future evaluations of HZ vaccination.