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Patient perspective on herpes zoster and its complications: an observational prospective study in patients aged over 50 years in general practice |
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| Authors: | Bouhassira Didier Chassany Olivier Gaillat Jacques Hanslik Thomas Launay Odile Mann Claude Rabaud Christian Rogeaux Olivier Strady Christophe |
| Affiliation: | a INSERM U987, Centre d’Evaluation et de Traitement de la Douleur, Hôpital Ambroise Paré, Boulogne-Billancourt F-92100, France b Université Versailles-Saint-Quentin, Versailles, F-78035, France c AP-HP, Département de la Recherche Clinique et du Développement, Hôpital Saint-Louis, Paris, France d Université Paris-Diderot, France e Service des Maladies Infectieuses, Centre Hospitalier de la Région d’Annecy, Pringy, France f Université Versailles Saint Quentin en Yvelines, Versailles, France g Assistance Publique Hôpitaux de Paris, Paris, France h Service de Médecine Interne, Hôpital Ambroise Paré, Boulogne-Billancourt, France i Faculté de Médecine, Université Paris Descartes, Paris, France j INSERM CIC BT505, Assistance Publique Hôpitaux de Paris, CIC de Vaccinologie Cochin Pasteur, Groupe Hospitalier, Broca-Cochin-Hôtel-Dieu, Paris, France k Service d’Anesthésie-Réanimation B, Hôpital Saint-Eloi, CHU de Montpellier, Montpellier, France l Service de Maladies Infectieuses et Tropicales, CHU de Nancy, Hôpitaux de Brabois, Vandoeuvre les Nancy, France m Infectiologie et maladies tropicales, Centre Hospitalier de Chambéry, Chambéry, France n Service de Maladies Infectieuses et Tropicales, CHU de Reims, Hôpital Robert Debré, Reims, France |
| Abstract: | Understanding the effect of herpes zoster and zoster-related pain should inform care to improve health-related quality of life in elderly patients. A 12-month, longitudinal, prospective, multicenter observational study conducted in primary care in France enrolled patients aged ?50 years with acute eruptive herpes zoster. Patient-reported zoster-related pain was assessed by validated questionnaires (Douleur Neuropathique en 4 Questions [DN4], Zoster Brief Pain Inventory [ZBPI], and Neuropathic Pain Symptom Inventory [NPSI]) on days 0 and 15, and at months 1, 3, 6, 9, and 12. Health-related quality of life was assessed by the 12-item short-form health survey (SF-12) and the Hospital Anxiety and Depression scale on day 0 and at months 3, 6, and 12. Of 1358 patients included, 1032 completed follow-up. Mean ± standard deviation age was 67.7 ± 10.7 (range, 50-95) years; 62.2% were women. Most patients (94.1%) were prescribed antiviral drugs. The prevalence of zoster-related pain on day 0 and at months 3, 6, 9, and 12 was 79.6%, 11.6%, 8.5%, 7.4%, and 6.0%, respectively. Patients with persistent pain had lower scores on the physical and mental component summaries of the SF-12 and the ZBPI interference score than those without pain. By logistic regression analysis, main predictive factors on day 0 for postherpetic neuralgia at month 3 were age, male sex, ZBPI interference score, Physical Component Summary score of the SF-12, and neuropathic quality of pain (DN4 score ?4). Despite early diagnosis and treatment with antiviral agents, many patients with herpes zoster experience persistent pain and marked long-term reduction in health-related quality of life. |
| Keywords: | Herpes zoster Neuropathic pain Postherpetic neuralgia Quality of life |
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