title: VZV skin-test reaction, but not antibody, is an important predictive factor for postherpetic neuralgia.
abstract: BACKGROUND
  The decline of cell-mediated immunity (CMI) is thought to be related to the risk of postherpetic neuralgia (PHN) as well as herpes zoster (HZ). However, the relationship between immunological condition and the incidence of PHN is still unclear.
  
  
  OBJECTIVE
  We conducted a large-scale prospective cohort study to clarify the relationship between immunological factors for varicella-zoster virus (VZV) and the incidence of PHN.
  
  
  METHODS
  We carried out a cohort study on VZV immunity in a population living on an island cluster, Shozu County in Japan, and examined the people who developed HZ during a follow-up period of 3 years, with a focus on the relationship between cell-mediated and humoral immunity and the incidence of PHN. A total of 12,522 people over the age of 50 were enrolled in this study, and 401 registrants were diagnosed with HZ, including 79 PHN cases. We evaluated anatomical location and severity of skin lesion, acute pain severity, presence or absence of abnormal sensations, CMI assessed by VZV skin test, and VZV-specific antibody titer measured by serological tests.
  
  
  RESULTS
  The incidence of PHN was significantly associated with a weak response to the VZV skin test, as well as facial or lumbosacral localization of skin rash, severe skin lesion, severe acute pain, and presence of abnormal sensations, but not related to VZV-specific antibody titer.
  
  
  CONCLUSIONS
  The incidence of PHN is significantly associated with the decline of VZV-specific CMI, but not related to VZV-specific humoral immunity.
authors.affiliation: Department of Dermatology, Nara Medical University School of Medicine, Nara, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Imoto
authors.affiliation: Department of Dermatology, Nara Medical University School of Medicine, Nara, Japan.
authors.forename: Aiko
authors.initials: A
authors.lastname: Okazaki
authors.affiliation: The Research Foundation for Microbial Diseases of Osaka University, Kagawa, Japan.
authors.forename: Fumitake
authors.initials: F
authors.lastname: Onishi
authors.affiliation: The Research Foundation for Microbial Diseases of Osaka University, Kagawa, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Miyazaki
authors.affiliation: The Research Foundation for Microbial Diseases of Osaka University, Kagawa, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Okeda
authors.affiliation: The Research Foundation for Microbial Diseases of Osaka University, Kagawa, Japan.
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Yano
authors.affiliation: The Research Foundation for Microbial Diseases of Osaka University, Kagawa, Japan; Public Health, Department of Social and Environmental Medicine, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Takao
authors.affiliation: The Research Foundation for Microbial Diseases of Osaka University, Kagawa, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Gomi
authors.affiliation: The Research Foundation for Microbial Diseases of Osaka University, Kagawa, Japan.
authors.forename: Toyokazu
authors.initials: T
authors.lastname: Ishikawa
authors.affiliation: The Research Foundation for Microbial Diseases of Osaka University, Kagawa, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Okuno
authors.affiliation: Division of Clinical Virology, Department of Microbiology and Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Mori
authors.affiliation: Public Health, Department of Social and Environmental Medicine, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Iso
authors.affiliation: The Research Foundation for Microbial Diseases of Osaka University, Kagawa, Japan; National Institute of Biomedical Innovation, Ibaraki, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Yamanishi
authors.affiliation: Department of Dermatology, Nara Medical University School of Medicine, Nara, Japan. Electronic address: asadah@naramed-u.ac.jp.
authors.forename: Hideo
authors.initials: H
authors.lastname: Asada
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000097:blood*; D005148:Facial Dermatoses / Q000453:epidemiology / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D006562:Herpes Zoster / Q000276:immunology*; D014645:Herpesvirus 3, Human / Q000276:immunology*; D006801:Humans; D007111:Immunity, Cellular; D056724:Immunity, Humoral; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D051474:Neuralgia, Postherpetic / Q000453:epidemiology* / Q000821:virology; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012678:Sensation Disorders / Q000453:epidemiology / Q000821:virology; D012720:Severity of Illness Index; D012882:Skin Tests
chemical_list: D000914:Antibodies, Viral