Clinical and Economic Impact of Herpes Zoster in Cancer Patients

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.

Inclusion Criteria Adults (≥18 years). Active solid or hematologic malignancy. Evaluation at A.C. Camargo Cancer Center (São Paulo, Brazil) between September 2019 and December 2024. Clinically confirmed episode of herpes zoster (initial episode or recurrence). Herpes zoster diagnosed based on a typical painful dermatomal rash with polymorphic lesions (macules, papules, vesicles, and crusts), either localized or disseminated. Exclusion Criteria Age \