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Observational Study
. 2018 Oct 3;18(1):496.
doi: 10.1186/s12879-018-3395-z.

Impact of herpes zoster and postherpetic neuralgia on the quality of life of Germans aged 50 or above

Desmond Curran  1 , Ruprecht Schmidt-Ott  2   3 , Ulf Schutter  4 , Jörg Simon  5 , Anastassia Anastassopoulou  6 , Sean Matthews  2
Affiliations
Observational Study

Impact of herpes zoster and postherpetic neuralgia on the quality of life of Germans aged 50 or above

Desmond Curran et al. BMC Infect Dis. .

Abstract

Background: Herpes zoster (HZ) is a painful dermatomal rash caused by reactivation of latent varicella zoster virus surviving in the patient's sensory ganglia after a previous episode of varicella. The incidence of HZ increases markedly with age as does the proportion of HZ patients who develop postherpetic neuralgia (PHN) with often severe and debilitating pain persisting for months and even years. This prospective study aimed to assess the impact of HZ and PHN on the quality of life (QoL) of individuals aged ≥ 50 years in Germany.

Methods: Patients were recruited when consulting primary care physicians for a first HZ episode. PHN was defined as a 'worst' pain score ≥ 3 on the Zoster Brief Pain Inventory (ZBPI) scale persisting or appearing 90 days or more after rash onset. PHN-cases were followed for up to nine months after rash onset. The interference of pain with patients' ability to carry out normal activities was assessed by the ZBPI activities of daily living (ADL) scale and QoL by the EuroQoL five-dimension scale (EQ-5D) utility score.

Results: Of 513 patients enrolled, 61 (11.9%) developed PHN. At HZ onset, the mean ZBPI worst pain score of all patients was 5.1, the least square (LS)means estimates of the ZBPI ADL and EQ-5D utility scores were 2.970 and 0.740, respectively. Over three months follow-up, the pain scores decreased and the QoL increased monotonically across all age groups. At Day 90, the mean ZBPI worst pain score of the PHN patients was 4.4, while the LSmeans estimates of the ZBPI ADL and EQ-5D utility scores were 2.899 and 0.826, respectively. For patients with PHN persisting at nine months, the pain scores and QoL remained unchanged over the six months following the development of PHN.

Conclusion: HZ and PHN had a substantial impact on the patients' QoL and ability to function in their normal activities. There was a clear association in time between the evolution of pain and estimated QoL. The impact on ADL and QoL did not vary with age.

Keywords: Activities of daily living; Herpes zoster; Pain; Postherpetic neuralgia; Quality of life; Zoster incidence.

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Conflict of interest statement

Ethics approval and consent to participate

The protocol was reviewed and approved by the ethics committees of the study areas (i.e. Landesärztekammer Hessen, Ethik-Kommission der Ärztekammer Nordrhein, and Ethik-Kommission der Medizinischen Fakultät der Universität Münster) and all enrolled patients gave written informed consent.

Consent for publication

Not Applicable.

Competing interests

RSO, DC and AA are employees of the GSK group of companies. DC and AA own stock options of the GSK group of companies. SM is a freelance consultant working on behalf of GSK Vaccines (Wavre, Belgium). JS has nothing to disclose. US received a grant from the GSK group of companies (as payment for advisory-board meeting) outside the submitted work.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart. *after rash onset; HZ herpes zoster; ZBPI zoster brief pain inventory; N total number; n number
Fig. 2
Fig. 2
Mean ZBPI worst pain scores up to day 90 after HZ onset according to age group. ZBPI zoster brief pain inventory; HZ herpes zoster; y years old
Fig. 3
Fig. 3
Percent of subjects with ZBPI ADL scores ≥ 5 after HZ onset by ADL individual items. ZBPI zoster brief pain inventory; HZ herpes zoster; ADL activities of daily living
Fig. 4
Fig. 4
Lay language summary
See this image and copyright information in PMC

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