title: Patient perspective on herpes zoster and its complications: an observational prospective study in patients aged over 50 years in general practice.
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.
authors.affiliation: INSERM U987, Centre d'Evaluation et de Traitement de la Douleur, Hôpital Ambroise Paré, Boulogne-Billancourt F-92100, France Université Versailles-Saint-Quentin, Versailles, F-78035, France AP-HP, Département de la Recherche Clinique et du Développement, Hôpital Saint-Louis, Paris, France Université Paris-Diderot, France Service des Maladies Infectieuses, Centre Hospitalier de la Région d'Annecy, Pringy, France Université Versailles Saint Quentin en Yvelines, Versailles, France Assistance Publique Hôpitaux de Paris, Paris, France Service de Médecine Interne, Hôpital Ambroise Paré, Boulogne-Billancourt, France Faculté de Médecine, Université Paris Descartes, Paris, France INSERM CIC BT505, Assistance Publique Hôpitaux de Paris, CIC de Vaccinologie Cochin Pasteur, Groupe Hospitalier, Broca-Cochin-Hôtel-Dieu, Paris, France Service d'Anesthésie-Réanimation B, Hôpital Saint-Eloi, CHU de Montpellier, Montpellier, France Service de Maladies Infectieuses et Tropicales, CHU de Nancy, Hôpitaux de Brabois, Vandoeuvre les Nancy, France Infectiologie et maladies tropicales, Centre Hospitalier de Chambéry, Chambéry, France Service de Maladies Infectieuses et Tropicales, CHU de Reims, Hôpital Robert Debré, Reims, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Bouhassira
authors.forename: Olivier
authors.initials: O
authors.lastname: Chassany
authors.forename: Jacques
authors.initials: J
authors.lastname: Gaillat
authors.forename: Thomas
authors.initials: T
authors.lastname: Hanslik
authors.forename: Odile
authors.initials: O
authors.lastname: Launay
authors.forename: Claude
authors.initials: C
authors.lastname: Mann
authors.forename: Christian
authors.initials: C
authors.lastname: Rabaud
authors.forename: Olivier
authors.initials: O
authors.lastname: Rogeaux
authors.forename: Christophe
authors.initials: C
authors.lastname: Strady
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology*; D059350:Chronic Pain / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006562:Herpes Zoster / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D051474:Neuralgia, Postherpetic / Q000453:epidemiology* / Q000523:psychology; D011446:Prospective Studies