ARIZONA study: is the risk of post-herpetic neuralgia and its burden increased in the most elderly patients?

BMC Infectious Diseases

Olivier Chassany⁶  Didier Bouhassira⁸  Christophe Strady⁷  Jacques Gaillat⁵  Sohéla El Kebir¹  Gaëtan Gavazzi⁴  Marc Paccalin²  Martin Duracinsky³ 

[1] Mapi, Real World Evidence, 69003 Lyon, France;Department of Geriatrics, La Milétrie Hospital, University Hospital of Poitiers, 86000 Poitiers, France;Internal Medicine and Clinical Immunology Department, AP-HP, Bicêtre Hospital, 94275 Cedex Le Kremlin-Bicêtre, France;Geriatric Medicine Department, A. Michallon North Hospital, University Hospital, 38700 La Tronche, France;Infectious Diseases Department, Annecy Regional Hospital, 74374 Pringy, France;Clinical Research and Development Department, AP-HP, Saint-Louis Hospital, 75010 Paris, France;Cabinet d’infectiologie, Clinique Saint André – Groupe Courlancy, 5 Boulevard de la paix, 51100 Reims, France;Versailles Saint-Quentin en Yvelines University, 78000 Versailles, France

关键词: Quality of life;    Neuropathic pain;    Post-herpetic neuralgia;    Herpes zoster;    Elderly;   

Others  :  1125463
DOI  :  10.1186/1471-2334-14-529

 received in 2014-05-18, accepted in 2014-09-16,  发布年份 2014

【 摘 要 】

Background

In a context of change in the demographic profile of the older population, to identify an age threshold for increased risk and burden of herpes zoster (HZ) in 70+ patients.

Methods

Post hoc analysis of the 12-month French nationwide prospective observational ARIZONA cohort study. HZ was assessed by means of the following validated questionnaires: Neuropathic Pain Symptom Inventory (NPSI), Zoster Brief Pain Inventory (ZBPI), Short-Form health survey (SF-12), and Hospital Anxiety and Depression Scale (HADS).

Results

644 general practitioners included 1,358 volunteer patients with acute HZ in the ARIZONA study; 609 patients (45%) were 70+. In 70+ patients, age did not increase rash severity or HZ-related pain intensity at diagnosis, but increased by 64% the frequency of ophthalmic zoster (from 5.5% in 70–74 years age-group to 9.0% in 85+ patients, p = NS). Age was significantly associated with low physical health as assessed by the SF-12 Physical Component Summary (SF-12 PCS) score and bad mood as assessed by the HADS depression score (p < 0.001). Within the year following HZ, post-herpetic neuralgia (PHN) was systematically but not significantly more frequent in 85+ patients than in the 70–74, 75–79, or 80–84 years age-groups (19.0% vs. 13.3%/15.3%/11.6% at month 3; 15.1% vs. 7.3%/11.0%/12.2% at month 6; 15.2% vs. 6.0%/8.0%/6.0% at month12, respectively). SF-12 PCS and HADS depression scores improved from day 0 to month 12 in all patients (p < 0.001). 85+ patients were more impaired than younger patients (p < 0.001), but without clear difference according to PHN.

Conclusions

This study did not show in 70+ patients a clear and significant age threshold at which disease burden increased, although for some domains the impact seemed higher among the oldest patients; the cut-off of 70 years remains thus relevant for clinical and epidemiological studies. However, at individual level, assessment of the burden of HZ and HZ-related pain appears necessary to improve management and prevent functional decline in the most vulnerable 70+ patients.

【 授权许可】

   
2014 Duracinsky et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Hope-Simpson RE: The nature of herpes zoster: a long-term study and a new hypothesis. Proc R Soc Med 1965, 58:9-20.
• [2]Arvin A: Aging, immunity, and the varicella-zoster virus. N Engl J Med 2005, 352(22):2266-2267.
• [3]Schmader K, Gnann JW Jr, Watson CP: The epidemiological, clinical, and pathological rationale for the herpes zoster vaccine. J Infect Dis 2008, 197(suppl 2):S207-S215.
• [4]Dworkin RH, Johnson RW, Breuer J, Gnann JW, Levin MJ, Backonja M, Betts RF, Gershon AA, Haanpaa ML, McKendrick MW, Nurmikko TJ, Oaklander AL, Oxman MN, Pavan-Langston D, Petersen KL, Rowbotham MC, Schmader KE, Stacey BR, Tyring SK, van Wijck AJ, Wallace MS, Wassilew SW, Whitley RJ: Recommendations for the management of herpes zoster. Clin Infect Dis 2007, 44:S1-S6.
• [5]Yawn BP, Saddier P, Wollan PC, St Sauver JL, Kurland MJ, Sy LS: A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction. Mayo Clin Proc 2007, 82(11):1341-1349.
• [6]Gauthier A, Breuer J, Carrington D, Martin M, Rémy V: Epidemiology and cost of herpes zoster and post-herpetic neuralgia in the United Kingdom. Epidemiol Infect 2009, 137(1):38-47.
• [7]Stein AN, Britt H, Harrison C, Conway EL, Cunningham A, Macintyre CR: Herpes zoster burden of illness and health care resource utilization in the Australian population aged 50 years and older. Vaccine 2009, 27(4):520-529.
• [8]Katz J, Cooper EM, Walther RR, Sweeney EW, Dworkin RH: Acute pain in herpes zoster and its impact on health-related quality of life. Clin Infect Dis 2004, 39(3):342-348.
• [9]Coplan PM, Schmader K, Nikas A, Chan IS, Choo P, Levin MJ, Johnson G, Bauer M, Williams HM, Kaplan KM, Guess HA, Oxman MN: Development of a measure of the burden of pain due to herpes zoster and postherpetic neuralgia for prevention trials: adaptation of the brief pain inventory. J Pain 2004, 5(6):344-356.
• [10]Oster G, Harding G, Dukes E, Edelsberg J, Cleary PD: Pain, medication use, and health-related quality of life in older persons with postherpetic neuralgia: results from a population-based survey. J Pain 2005, 6(6):356-363.
• [11]Johnson RW, Bouhassira D, Kassianos G, Leplège A, Schmader KE, Weinke T: The impact of herpes zoster and post-herpetic neuralgia on quality-of-life. BMC Med 2010, 8:37.
• [12]Johnson RW: Herpes zoster and postherpetic neuralgia: a review of the effects of vaccination. Aging Clin Exp Res 2009, 21(3):236-243.
• [13]Weinke T, Edte S, Schmitt S, Lukas K: Impact of herpes zoster and post-herpetic neuralgia on patients’ quality of life: a patient-reported outcomes survey. Z Gesundh Wiss 2010, 8(4):367-374.
• [14]Pickering G, Leplege A: Herpes zoster pain, postherpetic neuralgia, and quality of life in the elderly. Pain Pract 2010, 11(4):397-402.
• [15]Population Division, DESA, United Nations: World population ageing 1950–2050: executive summary. http://www.un.org/esa/population/publications/worldageing19502050/pdf/62executivesummary_english.pdf webcite
• [16]Bouhassira D, Chassany O, Gaillat J, Hanslik T, Launay O, Mann C, Rabaud C, Rogeaux O, Strady C: Patient perspective on herpes zoster and its complications: an observational prospective study in patients aged over 50 years in general practice. Pain 2012, 153(2):342-349.
• [17]Oxman MN, Levin MJ, Johnson GR, Schmader KE, Straus SE, Gelb LD, Arbeit RD, Simberkoff MS, Gershon AA, Davis LE, Weinberg A, Boardman KD, Williams HM, Zhang JH, Peduzzi PN, Beisel CE, Morrison VA, Guatelli JC, Brooks PA, Kauffman CA, Pachucki CT, Neuzil KM, Betts RF, Wright PF, Griffin MR, Brunell P, Soto NE, Marques AR, Keay SK, Goodman RP, et al.: A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N Engl J Med 2005, 352:2271-2284.
• [18]United Nations. Department of Economic and Social Affairs: Population Division: World Population Ageing 1950–2050. http://www.un.org/esa/population/publications/worldageing19502050/ webcite
• [19]Bouhassira D, Attal N, Fermanian J, Alchaar H, Gautron M, Masquelier E, Rostaing S, Lanteri-Minet M, Collin E, Grisart J, Boureau F: Development and validation of the Neuropathic Pain Symptom Inventory. Pain 2004, 108(3):248-257.
• [20]Schmader KE, Sloane R, Pieper C, Coplan PM, Nikas A, Saddier P, Chan IS, Choo P, Levin MJ, Johnson G, Williams HM, Oxman MN: The impact of acute herpes zoster pain and discomfort on functional status and quality of life in older adults. Clin J Pain 2007, 23(6):490-496.
• [21]Ware J Jr, Kosinski M, Keller SD: A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care 1996, 34(3):220-233.
• [22]Zigmond AS, Snaith RP: The hospital anxiety and depression scale. Acta Psychiatr Scand 1983, 67(6):361-370.
• [23]Drolet M, Brisson M, Levin MJ, Schmader KE, Oxman MN, Johnson RW, Camden S, Mansi JA: A prospective study of the herpes zoster severity of illness. Clinical J Pain 2010, 26(8):656-666.
• [24]Drolet M, Brisson M, Schmader KE, Levin MJ, Johnson R, Oxman MN, Patrick D, Camden S, Mansi JA: The impact of herpes zoster and postherpetic neuralgia on health-related quality of life: a prospective study. Can Med Assoc J 2010, 182(16):1731-1736.
• [25]Drolet M, Brisson M, Schmader KE, Levin M, Johnson R, Oxman M, Patrick D, Blanchette C, Mansi JA: Predictors of postherpetic neuralgia among patients with herpes zoster: a prospective study. J Pain 2010, 11(11):1211-1221.
• [26]Kawai K, Gebremeskel BG, Acosta CJ: Systematic review of incidence and complications of herpes zoster: towards a global perspective. BMJ Open 2014, 4(6):e004833. 10
• [27]Helgason S, Petursson G, Gudmundsson S, Sigurdsson JA: Prevalence of postherpetic neuralgia after a single episode of herpes zoster: prospective study with long term follow up. BMJ 2000, 321:1-4.
• [28]Li Q, Chen N, Yang J, Zhou M, Zhou D, Zhang Q, He L: Antiviral treatment for preventing postherpetic neuralgia. Cochrane Database Syst Rev 2009., 2CD006866
• [29]Bruxelle J, Pinchinat S: Effectiveness of antiviral treatment on acute phase of herpes zoster and development of post herpetic neuralgia: review of international publications. Med Mal Infect 2012, 42(2):53-58.
• [30]Morrison VA, Oxman MN, Levin MJ, Schmader KE, Guatelli JC, Betts RF, Gelb LD, Pachucki CT, Keay SK, Menzies B, Griffin MR, Kauffman CA, Marques AR, Toney JF, Simberkoff MS, Serrao R, Arbeit RD, Gnann JW, Greenberg RN, Holodniy M, Keitel WA, Yeh SS, Davis LE, Crawford GE, Neuzil KM, Johnson GR, Zhang JH, Harbecke R, Chan IS, Keller PM, et al.: Safety of zoster vaccine in elderly adults following documented herpes zoster. J Infect Dis 2013, 208(4):559-563.
• [31]Szucs TD, Pfeil AM: A systematic review of the cost effectiveness of herpes zoster vaccination. Pharmacoeconomics 2013, 31(2):125-136.
• [32]Bresse X, Annemans L, Préaud E, Bloch K, Duru G, Gauthier A: Vaccination against herpes zoster and postherpetic neuralgia in France: a cost-effectiveness analysis. Expert Rev Pharmacoecon Outcomes Res 2013, 13(3):393-406.
• [33]Hales CM, Harpaz R, Ortega-Sanchez I, Bialek SR, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC: Update on recommendations for use of herpes zoster vaccine. MMWR Morb Mortal Wkly Rep 2014, 63(33):729-731.
• [34]Rittger H, Rieber J, Breithardt OA, Dücker M, Schmidt M, Abbara S, Sinha AM, Jakob A, Nölker G, Brachmann J: Influence of age on pain perception in acute myocardial ischemia: a possible cause for delayed treatment in elderly patients. Intern J Cardiol 2011, 149:63-67.
• [35]Dorr DA, Jones SS, Burns L, Donnelly SM, Brunker CP, Wilcox A, Clayton PD: Use of health related, quality-of-life metrics to predict mortality and hospitalization in community-dwelling seniors. J Am Geriatr Soc 2006, 54:667-673.
• [36]Frieling MA, Davis WR, Chiang G: The SF-36v2 and SF-12v2 health surveys in New Zealand: norms, scoring coefficients and cross country comparisons. Aust N Z Public Health 2013, 37(1):24-31.
• [37]Gil-Prieto R, San-Martin M, Alvaro-Meca A, Gonzalez-Lopez A, Gil de Miguel A: Herpes zoster hospitalizations of patients with chronic illnesses in Spain 1998–2004. Vacunas 2011, 12:95-101.
• [38]Rockwood K, Fox RA, Stolee P, Robertson D, Beattie BL: Frailty in elderly people: an evolving concept. CMAJ 1994, 150:489-495.