Therapeutic experiences for herpes zoster and risk factors for zoster-associated pain: a retrospective single-center observational study

Therapeutic experiences for herpes zoster and risk factors for zoster-associated pain: a retrospective single-center observational study

Herpes zoster (HZ) is generally treated with antiviral drugs; however, additional pharmacological and non-pharmacological treatments are required depending on the patient’s condition. Some patients develop zoster-associated pain (ZAP), which is pain that persisted after HZ treatment. Interest is growing on whether treatments for HZ contribute to preventing ZAP. However, evidence is insufficient to conclude whether these treatments for HZ are effective for ZAP prevention. Therefore, this retrospective study aimed to analyze the HZ treatment experience, ZAP occurrence, and risk factors for ZAP development. The numeric rating scale (NRS) score for pain was recorded on admission, discharge, and 1, 3, and 6 months after discharge. Data on the prescription patterns for HZ treatment were collected. Antiviral treatment was started within 72 h after the onset of rash in 55.9% of the patients and was continued for ≥5 days in 62.7%. Moreover, an ≥4 NRS score was noted in 1.9% of the patients at discharge compared with 85.2% on admission. ZAP occurred in 17.9% of the patients 6 months after discharge. Risk factors of ZAP were truncal lesions, severe pain, antiviral treatment for ≥5 days, and antibiotic treatment. Risk factors of ZAP with ≥4 NRS score were older age, severe pain, antiviral treatment for ≥5 days, and tricyclic antidepressant therapy. However, further research on subgroups receiving treatment combinations is needed to evaluate the synergistic or additive effect on preventing ZAP after HZ treatment.