The impact of herpes zoster and postherpetic neuralgia on health-related quality of life: a prospective study

Abstract

Background: Vaccination against herpes zoster is being considered in many countries. We conducted a multicentre prospective study to describe the impact of herpes zoster and postherpetic neuralgia on health-related quality of life.

Methods: From October 2005 to July 2006, 261 outpatients aged 50 years or older with herpes zoster were recruited from the clinical practices of 83 physicians within 14 days after rash onset. The Zoster Brief Pain Inventory was used to measure severity of pain and interference with activities of daily living because of pain. The EuroQol EQ-5D assessment tool was used to measure quality of life. These outcomes were assessed at recruitment and on days 7, 14, 21, 30, 60, 90, 120, 150 and 180 following recruitment.

Results: Acute herpes zoster interfered in all health domains, especially sleep (64% of participants), enjoyment of life (58%) and general activities (53%). The median duration of pain was 32.5 days. The median duration of interference with activities of daily living because of pain varied between 27 and 30 days. Overall, 24% of the participants had postherpetic neuralgia (pain for more than 90 days after rash onset). Anxiety and depression, enjoyment of life, mood and sleep were most frequently affected during the postherpetic neuralgia period. The mean EQ-5D score was 0.59 at enrolment and remained at 0.67 at all follow-up points among participants who reported clinically significant pain.

Interpretation: These data support the need for preventive strategies and additional early intervention to reduce the burden of herpes zoster and postherpetic neuralgia.

Figure 1

Impact of herpes zoster on health-related quality of life. Shown are the percentages of participants (n = 261) who reported problems in the EuroQol EQ-5D domains at the time of recruitment (< 14 days after rash onset) and after the pain stopped. Median duration of pain was 32.5 days. Error bars = 95% confidence intervals.

Figure 2

Change in health-related quality of life over time, as indicated by change in mean EuroQol EQ-5D scores, among patients with herpes zoster. Dotted lines represent 95% confidence intervals.

Figure 3

Impact of postherpetic neuralgia on health-related quality of life. Shown are the percentages of participants with postherpetic neuralgia (n = 63) who reported problems in the EuroQol EQ-5D domains at 90 days after rash onset (the start of the postherpetic neuralgia) and at 180 days after rash onset. Error bars = 95% confidence intervals.