title: One-year follow-up of patients with long-lasting post-herpetic neuralgia.
abstract: BACKGROUND
  Recent information on epidemiology and management of post-herpetic neuralgia (PHN), a painful complication of zoster, is scarce.
  
  
  METHODS
  This study was conducted at the Pain Clinic of the Policlinico Tor Vergata, Rome, Italy, on eighty-five immunocompetent patients with a clinical diagnosis of PHN. At enrollment (time 0, T0), the patients were interviewed by physicians to obtain demographic data and information about their zoster clinical history and underwent a blood test for VZV-DNA research. DN4 and SF-12 questionnaires were used to assess the neuropathic nature of pain and the overall health status, respectively. A one-year follow-up was planned for enrolled cases, who were visited at regular intervals of at least 3 months.
  
  
  RESULTS
  At T0 all the patients were at least 6 months from the episode of acute zoster and still presented with intense pain (mean VAS =6.7; mean DN4 = 5.7). Using antivirals within 72 hours from the rash onset was associated to a significant reduction of pain at T0 (p = 0.006 vs untreated patients). Only 2.6% of patients treated with antivirals during acute zoster but 18.6% of the untreated ones presented with neuropathic pain at T12 (p =0.007), even though the two groups were similar at T0. VZV-DNA was found in 5 out of the 50 available blood samples. At the last follow-up visit, PCS and MCS scores of the PHN patients were found to be recovered over those of the historical age-matched healthy controls. Undesirable side effects of analgesic therapies were observed in 15.3 to 28.8% of the patients.
  
  
  CONCLUSIONS
  Patients who six months after acute zoster still have significant neuropathic pain, have a high probability of suffering from chronic pain in the subsequent months/years. The initial antiviral treatment has a significant impact on the pain. Current strategies of analgesic therapy are effective to achieve relief of pain in PHN patients, but they are burdened with heavy and undesirable side effects.
authors.forename: Francesca
authors.initials: F
authors.lastname: Pica
authors.forename: Antonio
authors.initials: A
authors.lastname: Gatti
authors.forename: Marco
authors.initials: M
authors.lastname: Divizia
authors.forename: Marzia
authors.initials: M
authors.lastname: Lazzari
authors.forename: Marco
authors.initials: M
authors.lastname: Ciotti
authors.forename: Alessandro Fabrizio
authors.initials: AF
authors.lastname: Sabato
authors.forename: Antonio
authors.initials: A
authors.lastname: Volpi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D005076:Exanthema / Q000139:chemically induced; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy*; D051474:Neuralgia, Postherpetic / Q000188:drug therapy*; D012306:Risk; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000700:Analgesics