We examined the incidence of herpes zoster in immunocompromised adults (≥18 years) with different severities of immunosuppression and assessed the prevalence of complications and of various kinds of healthcare resource utilisation.

German claims data from more than ten million adults were used to calculate annual incidence rates of herpes zoster for the years 2006–2012 and to analyse the prevalence of complications, physician visits, hospitalisations, and antiviral and analgesic treatments using a cohort design. The analyses were stratified by age, sex, and severity of immunosuppression, defined by immunocompromising conditions and drug therapies.

The incidence rate per 1000 person-years of herpes zoster was almost twice as high in immunocompromised patients (11.5 (95% confidence interval (CI): 11.4–11.6)) compared to immunocompetent subjects (5.9 (95% CI: 5.8–5.9)). The incidence rate was higher in highly immunocompromised patients (13.4 (95% CI: 13.2–13.6)) than in patients with a low severity of immunosuppression (10.0 (95% CI: 9.8–10.1)). These differences were observed for both sexes and in all age groups. Complications, outpatient physician visits, hospitalisations, and analgesic treatments occurred more frequently in immunocompromised patients as well.

Our results show that immunocompromised individuals are affected by the disease in particular and that the burden of herpes zoster is highest in severely immunocompromised patients.