title: Burden of herpes zoster-associated chronic pain in Italian patients aged 50 years and over (2009-2010): a GP-based prospective cohort study.
abstract: BACKGROUND
  Post-herpetic neuralgia (PHN) is the most common complication in herpes zoster (HZ) patients.
  
  
  METHODS
  We performed a longitudinal, prospective study in 108 general practices throughout Italy to assess how many immunocompetent patients aged ≥50 years with newly diagnosed HZ develop HZ-associated pain, its duration and management over 6-months. HZ-associated pain was assessed by a direct question to the patient and by self-assessment of the worst pain felt in the previous two weeks on a visual analogue scale (VAS), a score ≥3 was taken as pain. PHN was defined as pain reported during the study period persisting for ≥3 months. Quality of life (QoL) was measured using the SF-12 questionnaire.
  
  
  RESULTS
  At enrolment, 370 of the 413 patients (89.6%) reported HZ-associated pain which was still present in 20.6% and 9.2% of patients after three and six months, respectively, despite many patients receiving recommended anti-viral therapy. The overall QoL scores were lower than those in healthy Italians of similar age; scores for patients with HZ-associated pain were lower. The presence of >50 vesicles and VAS score ≥3 at enrolment, and being male were significantly associated with PHN at three months.
  
  
  CONCLUSIONS
  These results suggest that HZ and PHN represent an important burden of disease in the elderly. There is a need for interventions that can prevent and reduce the burden of HZ to help improve the quality of life of the elderly. These data may be useful as baseline epidemiology data for the assessment of the impact of the VZV vaccine in Italy, after its implementation.
authors.affiliation: Epidemiological Department, Sanofi Pasteur MSD, Lyon, France. hbricout@spmsd.com.
authors.forename: Hélène
authors.initials: H
authors.lastname: Bricout
authors.affiliation: Medical & Scientific Department, Sanofi Pasteur MSD, Rome, Italy. eperinetti@spmsd.com.
authors.forename: Emilia
authors.initials: E
authors.lastname: Perinetti
authors.affiliation: Pain Medicine Center, Hospital San Raffaele of Milan, Milan, Italy. marchettini.paolo@hsr.it.|Pain Pathophysiology and Therapy, University School of Italian Switzerland, Manno, Lugano, Switzerland. marchettini.paolo@hsr.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Marchettini
authors.affiliation: Local Health Authority for Reggio Emilia, Emilia Romagna, Italy. pietro.ragni@ausl.re.it.
authors.forename: Pietro
authors.initials: P
authors.lastname: Ragni
authors.affiliation: Department of Public Health and Paediatrics, University of Turin, Turin, Italy. carla.zotti@unito.it.
authors.forename: Carla Maria
authors.initials: CM
authors.lastname: Zotti
authors.affiliation: Department of Medical Sciences, University of Ferrara, Ferrara, Italy. giovanni.gabutti@unife.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gabutti
authors.affiliation: Department of Clinical Sciences, University of Rome Tor Vergata, Rome, Italy. volpi@med.uniroma2.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Volpi
authors.affiliation: Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy. franco@med.uniroma2.it.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Franco
mesh_terms: D000368:Aged; D059350:Chronic Pain; D015331:Cohort Studies; D005260:Female; D058006:General Practice; D006562:Herpes Zoster / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D053061:Herpes Zoster Vaccine; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D051474:Neuralgia, Postherpetic / Q000150:complications; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D053061:Herpes Zoster Vaccine