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Risk factors for postherpetic neuralgia
P W Choo1, K Galil, J G Donahue
1Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, Mass, USA.
Archives of Internal Medicine
|June 9, 1997
Summary
Older age and prodromal symptoms significantly increase the risk of postherpetic neuralgia (PHN) after herpes zoster. Acyclovir treatment did not show overall protection against PHN development.
Area of Science:
- Epidemiology
- Virology
- Neurology
Background:
- Postherpetic neuralgia (PHN) is the most frequent complication of herpes zoster.
- Established risk factors for PHN remain poorly understood, necessitating further investigation.
Purpose of the Study:
- To identify and elucidate the key risk factors associated with the development of PHN.
- To assess the impact of patient, disease, and treatment variables on PHN prevalence.
Main Methods:
- A case-base design was employed using automated medical, claims, and pharmacy records.
- Data from 821 herpes zoster cases were analyzed to determine PHN prevalence at 30 and 60 days post-onset.
- Patient demographics, prodromal symptoms, immune status, and treatments were evaluated as potential risk factors.
Main Results:
- PHN prevalence was 8.0% at 30 days and 4.5% at 60 days post-zoster onset.
- Individuals aged 50 years and older had significantly higher PHN prevalence compared to younger patients (14.7-fold at 30 days, 27.4-fold at 60 days).
- Prodromal sensory symptoms and conditions linked to compromised immunity were associated with increased PHN risk. Pre-zoster corticosteroid use and zoster treatment with acyclovir or corticosteroids did not significantly alter PHN prevalence.
Conclusions:
- Advanced age and the presence of prodromal symptoms are significant predictors of higher PHN prevalence.
- Systemic acyclovir does not appear to offer protection against PHN, though a potential benefit in elderly patients cannot be ruled out.