Abstract
BackgroundPost-herpetic neuralgia (PHN) is the most common complication in herpes zoster (HZ) patients.MethodsWe performed a longitudinal, prospective study in 108 general practices throughout Italy to assess how many immunocompetent patients aged ≥50 years with newly diagnosed HZ develop HZ-associated pain, its duration and management over 6-months. HZ-associated pain was assessed by a direct question to the patient and by self-assessment of the worst pain felt in the previous two weeks on a visual analogue scale (VAS), a score ≥3 was taken as pain. PHN was defined as pain reported during the study period persisting for ≥3 months. Quality of life (QoL) was measured using the SF-12 questionnaire.ResultsAt enrolment, 370 of the 413 patients (89.6%) reported HZ-associated pain which was still present in 20.6% and 9.2% of patients after three and six months, respectively, despite many patients receiving recommended anti-viral therapy. The overall QoL scores were lower than those in healthy Italians of similar age; scores for patients with HZ-associated pain were lower. The presence of >50 vesicles and VAS score ≥3 at enrolment, and being male were significantly associated with PHN at three months.ConclusionsThese results suggest that HZ and PHN represent an important burden of disease in the elderly. There is a need for interventions that can prevent and reduce the burden of HZ to help improve the quality of life of the elderly. These data may be useful as baseline epidemiology data for the assessment of the impact of the VZV vaccine in Italy, after its implementation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0637-6) contains supplementary material, which is available to authorized users.
Highlights
Post-herpetic neuralgia (PHN) is the most common complication in herpes zoster (HZ) patients
Patient population A total of 108 of the 147 general practitioner (GP) who accepted to participate in the study included at least one patient
The Physical component score (PCS-12) and Mental component score (MCS-12) scores in patients presenting with pain at the respective visit did not vary, except for a small decrease in the MCS-12 score (Table 3). The results from this prospective study, performed in a large network of GPs in Italy, show that patients aged ≥50 years report that HZ is painful, it has a negative impact on their quality of life (QoL), working patients need to take sick leave and increasing age is a risk factor for severity
Summary
Post-herpetic neuralgia (PHN) is the most common complication in herpes zoster (HZ) patients. Varicella zoster virus (VZV) is a herpes virus that infects most humans in temperate regions resulting in a highly contagious primary infection of varicella, usually in childhood [1]. After this infection, the virus remains latent in sensory ganglia until it is reactivated to cause herpes zoster (HZ) [2]. In Europe, almost all adults (>95%) are healthy carriers of VZV following childhood varicella and are, at risk of developing HZ [3]. The incidence and severity (number of vesicles, and pain intensity and duration) of HZ increase with age, but it is difficult to predict who will develop HZ [5,6]. Other risk factors include sex, ethnicity, genetic susceptibility, familial history of HZ, mechanical trauma, psychological stress, depression and diabetes [7,8,9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
