VZV skin-test reaction, but not antibody, is an important predictive factor for postherpetic neuralgia

J Dermatol Sci. 2015 Sep;79(3):235-40. doi: 10.1016/j.jdermsci.2015.05.011. Epub 2015 Jun 1.

Abstract

Background: The decline of cell-mediated immunity (CMI) is thought to be related to the risk of postherpetic neuralgia (PHN) as well as herpes zoster (HZ). However, the relationship between immunological condition and the incidence of PHN is still unclear.

Objective: We conducted a large-scale prospective cohort study to clarify the relationship between immunological factors for varicella-zoster virus (VZV) and the incidence of PHN.

Methods: We carried out a cohort study on VZV immunity in a population living on an island cluster, Shozu County in Japan, and examined the people who developed HZ during a follow-up period of 3 years, with a focus on the relationship between cell-mediated and humoral immunity and the incidence of PHN. A total of 12,522 people over the age of 50 were enrolled in this study, and 401 registrants were diagnosed with HZ, including 79 PHN cases. We evaluated anatomical location and severity of skin lesion, acute pain severity, presence or absence of abnormal sensations, CMI assessed by VZV skin test, and VZV-specific antibody titer measured by serological tests.

Results: The incidence of PHN was significantly associated with a weak response to the VZV skin test, as well as facial or lumbosacral localization of skin rash, severe skin lesion, severe acute pain, and presence of abnormal sensations, but not related to VZV-specific antibody titer.

Conclusion: The incidence of PHN is significantly associated with the decline of VZV-specific CMI, but not related to VZV-specific humoral immunity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antibodies, Viral / blood*
  • Facial Dermatoses / epidemiology
  • Facial Dermatoses / virology
  • Female
  • Follow-Up Studies
  • Herpes Zoster / immunology*
  • Herpesvirus 3, Human / immunology*
  • Humans
  • Immunity, Cellular
  • Immunity, Humoral
  • Incidence
  • Japan / epidemiology
  • Lumbosacral Region
  • Male
  • Middle Aged
  • Neuralgia, Postherpetic / epidemiology*
  • Neuralgia, Postherpetic / virology
  • Pain Measurement
  • Predictive Value of Tests
  • Prospective Studies
  • Sensation Disorders / epidemiology
  • Sensation Disorders / virology
  • Severity of Illness Index
  • Skin Tests

Substances

  • Antibodies, Viral