Incidence and risk of postherpetic neuralgia after varicella zoster virus infection in hematopoietic cell transplantation recipients: Hokkaido Hematology Study Group.
To assess the incidence of and risk factors associated with postherpetic neuralgia (PHN) after hematopoietic cell transplantation (HCT) varicella zoster virus (VZV) infection, we conducted a retrospective chart review of 418 consecutive patients who underwent HCT between April 2005 and March 2007. The male/female ratio was 221/197, median age at HCT was 47 years (range: 0-69 years), and autologous/allogeneic/syngeneic HCT ratio was 154/263/1. Seventy-eight patients developed VZV infection after HCT. Sixty-two patients had localized zoster, 11 patients had disseminated zoster (rash like chicken pox), and 4 patients had visceral zoster. All cases were treated with acyclovir (ACV) or valacyclovir (VACV), and there was no VZV infection-related death. Twenty-seven (35%) of the 78 patients with VZV infection suffered PHN after resolution of VZV infection. Multivariate analysis showed that advanced age is the only risk factor in autologous HCT (P = .0075; odds ratio [OR] = 1.14; 95% confidence interval [CI], 0.97-1.33). On the other hand, advanced age (P = .0097; OR = 1.06; 95% CI, 1.01-1.12), male gender (P = .0055; OR = 12.7; 95% CI, 1.61-100.1), and graft-versus-host disease (GVHD) prophylaxis with a tacrolimus-based regimen (P = .0092; OR = 9.56; 95% CI, 1.44-63.3) were associated with increased risk of PHN in allogeneic HCT. This study for the first time clarified the risk of PHN in HCT recipients.
Onozawa
Masahiro
M
Stem Cell Transplantation Center, Hokkaido University Graduate School of Medicine, Sapporo, Japan. masahiro.onozawa@nifty.ne.jp).
Hashino
Satoshi
S
Haseyama
Yoshifumi
Y
Hirayama
Yasuo
Y
Iizuka
Susumu
S
Ishida
Tadao
T
Kaneda
Makoto
M
Kobayashi
Hajime
H
Kobayashi
Ryoji
R
Koda
Kyuhei
K
Kurosawa
Mitsutoshi
M
Masauji
Nobuo
N
Matsunaga
Takuya
T
Mori
Akio
A
Mukai
Masaya
M
Nishio
Mitsufumi
M
Noto
Satoshi
S
Ota
Shuichi
S
Sakai
Hajime
H
Suzuki
Nobuhiro
N
Takahashi
Tohru
T
Tanaka
Junji
J
Torimoto
Yoshihiro
Y
Yoshida
Makoto
M
Fukuhara
Takashi
T
D000212:Acyclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D002644:Chickenpox / Q000150:complications* / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D005260:Female; D030342:Genetic Diseases, Inborn / Q000150:complications; D018380:Hematopoietic Stem Cell Transplantation; D006562:Herpes Zoster / Q000150:complications* / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000601:surgery; D051474:Neuralgia, Postherpetic / Q000453:epidemiology* / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012306:Risk; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D000077483:Valacyclovir; D014633:Valine / Q000031:analogs & derivatives / Q000627:therapeutic use; D014775:Virus Activation; D055815:Young Adult
D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir