South Clin Ist Euras. 2023; 34(3): 279-282 | DOI: 10.14744/scie.2021.43760

Risk Factors for Postherpetic Neuralgia in Immunocompetent Patients

Yasemin Nadir¹, Hüseyin Arslan^2
1Department of Infectious Diseases and Clinical Microbiology, Sandýklý State Hospital, Afyonkarahisar, Türkiye
²Department of Clinic of Physical Medicine and Rehabilitation, Sandýklý State Hospital, Afyonkarahisar, Türkiye

INTRODUCTION: The most common and important complication of herpes zoster (HZ) is postherpetic neuralgia (PHN). PHN generally affects the elderly and immunocompromised populations. Many studies investigated the risk factors for PHN; however, these studies were generally performed among immunocompromised patients. This study aimed to quantify risk factors for PHN in immunocompetent zoster patients.
METHODS: We retrospectively reviewed the records of 106 patients diagnosed with HZ and aged ≥18 years between January 2017 and May 2019. Eight participants with immunocompromised status or under immunosuppressive treatment were excluded. Our underlying definition of PHN was pain persisting for more than 90 days following the diagnosis of zoster. Patients were divided into the PHN group (n=18) and the non-PHN group (n=80) on the basis of occurrence of PHN. Variables that can affect the development of PHN were investigated by comparing these two groups.
RESULTS: In total, 98 eligible patients were included in this study. The mean age of the patients was 58.62±17.53 years. PHN was determined in 18.4% of the patients. PHN was mostly seen in the autumn. Patients in the PHN group were significantly older (mean age 68.72 years) than patients in the non-PHN group (56.35 years). PHN was higher in patients with chronic diseases. Patients with nonthoracic dermatome involvement were more likely to get PHN. There were no proportional differences detected between genders, and there were no differences between antiviral drug groups for PHN incidence.
DISCUSSION AND CONCLUSION: In this study, having chronic disease, increased age, and nonthoracic dermatome involvement were found to be risk factors for developing PHN among immunocompetent hosts. As a new finding, we found that PHN has a higher incidence in autumn.

Keywords: Herpes zoster, postherpetic neuralgia, risk factors.

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Ýmmünkompetan Bireylerde Postherpetik Nevralji Ýçin Risk Faktörleri

Yasemin Nadir¹, Hüseyin Arslan^2
1Sandýklý Devlet Hastanesi, Enfeksiyon Hastalýklarý ve Klinik Mikrobiyoloji
²Sandýklý Devlet Hastanesi, Fizik Tedavi ve Rehabilitasyon

GÝRÝÞ ve AMAÇ: Postherpetik nevralji (PHN), Herpes zosterin (HZ) en önemli komplikasyonudur. Özellikle yaþlý ve immünsupresif bireylerde sýklýkla görüldüðü bilinmektedir. Bu nedenle immünsupresif HZ’li hastalar arasýnda PHN risk faktörlerini araþtýran birçok çalýþma yapýlmýþtýr. Biz de çalýþmamýzda immünkompetan bireylerdeki PHN risk faktörlerini araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Bu çalýþmada, Ocak 2017–Mayýs 2019 tarihleri arasýnda baþvuran 18 yaþ üzeri ve klinik olarak akut HZ tanýsý alan 106 hastanýn kayýtlarýný geriye dönük olarak taradýk. Ýmmünsupresif hastalýðý olan veya immünsupresif ilaç kullanan sekiz hasta çalýþmaya dahil edilmedi. HZ tanýsýndan sonra en az 90 gün devam eden aðrý PHN olarak deðerlendirildi ve buna göre hastalar iki grupta incelendi; PHN (n=18) ve nonPHN grubu (n=80). PHN geliþimini etkileyebilecek deðiþkenler bu iki grup kýyaslanarak incelendi.
BULGULAR: Çalýþmaya alýnan 98 hastanýn yaþ ortalamasý 58.62±17.53 yaþ olarak saptandý. Bu hastalarýn %18.4’ünde PHN geliþti. PHN geliþen hastalarýn sýklýkla hastaneye sonbaharda baþvurduðu gözlendi. PHN grubun yaþ ortalamasý (68.72) istatistiksel olarak nonPHN grubun yaþ ortalamasýndan (56.35) yüksek bulundu. Kronik hastalýðý olan hastalarda, olmayanlara göre PHN geliþimi daha sýk saptandý. PHN geliþen hastalarda torasik tutulum daha sýk görülse de, nontorasik tutulumu olanlarýn daha yüksek oranda PHN geliþtirdiði gözlemlendi. Ancak cinsiyet ve hastalarýn kullandýðý ilaç gruplarý açýsýndan anlamlý bir farklýlýk bulunamadý.
TARTIÞMA ve SONUÇ: Bu çalýþmada, HZ’li olan immünkompetan bireylerde; ileri yaþ, kronik hastalýðýn olmasý ve nontorasik dermatom tutulumunun olmasý PHN için risk faktörü olarak saptandý. Çalýþmamýzda sonbahar mevsiminde baþvuran hastalarda istatistiksel olarak yüksek oranda PHN geliþtiðinin gözlenmesi dikkat çekici bir bulguydu.

Anahtar Kelimeler: Herpes zoster, postherpetik nevralji, risk faktörleri.

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