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

ABSTRACT 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 Among 27,868 participants (21,496 adults; 6372 minors), 809 adult HZ cases were identified, with 64.40% ( n = 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.