title: Predictors of postherpetic neuralgia in patients with herpes zoster: a pooled analysis of prospective cohort studies from North and Latin America and Asia.
abstract: OBJECTIVE
  The most common complication of herpes zoster (HZ) is postherpetic neuralgia (PHN), a persistent pain that can substantially affect quality of life (QoL). This analysis aimed to evaluate predictors of PHN in HZ patients.
  
  
  METHODS
  A pooled analysis of prospective cohort studies of HZ patients aged ≥ 50 years from North America (Canada), Latin America (Brazil, Mexico, and Argentina), and Asia (Taiwan, South Korea, and Thailand) was performed. Patients within 14 days of rash onset were included. The incidence of PHN was defined as a worst pain score of ≥ 3, persisting/appearing at >90 days after rash onset. Socio-demographics, HZ disease characteristics, treatment, pain-related interference with activities of daily living, and health-related QoL were assessed.
  
  
  RESULTS
  Of 702 patients with HZ, 148 (21.1%) developed PHN. Similar risks of PHN were observed across geographic regions. On multivariate analysis, older age, greater severity of pain at rash onset, employment status, walking problems at enrollment, and pain interference affecting social relationships were significantly associated with the development of PHN.
  
  
  CONCLUSIONS
  In addition to older age and severe acute pain, this study suggests that impaired physical and social functioning from acute zoster pain may play a role in the development of PHN in this prospective cohort study of HZ patients from North and Latin America and Asia.
authors.affiliation: Global Health Outcomes, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania, PA 19486, USA. Electronic address: kkawai8@gmail.com.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Kawai
authors.affiliation: JSS Medical Research, St-Laurent, Quebec, Canada.
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Rampakakis
authors.affiliation: Department of Dermatology, National Taiwan University Hospital, Zhongzheng District, Taipei City, Taiwan.
authors.forename: Tsen-Fang
authors.initials: TF
authors.lastname: Tsai
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea.
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Cheong
authors.affiliation: Clinical Infectious Disease Research Unit, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Phutthamonthon District, Nakhon Pathom, Bangkok, Thailand.
authors.forename: Jittima
authors.initials: J
authors.lastname: Dhitavat
authors.affiliation: Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.
authors.forename: Alejandro Ortiz
authors.initials: AO
authors.lastname: Covarrubias
authors.affiliation: JSS Medical Research, St-Laurent, Quebec, Canada.
authors.forename: Lin
authors.initials: L
authors.lastname: Yang
authors.affiliation: Vaccines Latin America and the Caribbean, MSD Corp., Mexico City, DF, Mexico.
authors.forename: Miguel
authors.initials: M
authors.lastname: Cashat-Cruz
authors.affiliation: Latin America Health Outcomes Research, MSD (I.A.) Corp., Carolina, Puerto Rico.
authors.forename: Homero
authors.initials: H
authors.lastname: Monsanto
authors.affiliation: Global Health Outcomes, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania, PA 19486, USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Johnson
authors.affiliation: JSS Medical Research, St-Laurent, Quebec, Canada; McGill University, Montreal, Quebec, Canada.
authors.forename: John S
authors.initials: JS
authors.lastname: Sampalis
authors.affiliation: Global Health Outcomes, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania, PA 19486, USA.
authors.forename: Camilo J
authors.initials: CJ
authors.lastname: Acosta
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001118:Argentina / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D005076:Exanthema / Q000453:epidemiology; D005260:Female; D006562:Herpes Zoster / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D051474:Neuralgia, Postherpetic / Q000453:epidemiology*; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D056910:Republic of Korea / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology; D013785:Thailand / Q000453:epidemiology
keywords: Asia; Herpes zoster; Latin America; North America; Postherpetic neuralgia; Predictors