BackgroundHerpes 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.MethodsPatients 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.ResultsOf 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.ConclusionHZ 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.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3395-z) contains supplementary material, which is available to authorized users.

The study confirmed previous findings that HZ causes a substantial clinical and economic burden in older German adults. It also confirmed the age-related increasing risk of HZ and PHN.

symptoms and functioning at baseline. For most patients, symptom scores improved during treatment which is consistent with the reduction in HCV-related symptoms reported in the trials. Reliability was acceptable (Cronbach's α ≥ 0.7, test-retest ICC ≥ 0.7) for most scores except the HCV-SIQv4 Gastrointestinal and Integumentary domain scores. Convergent validity was observed between PRO scores and concurrent measures of the same concept. Greater symptom severity and worse impact scores were associated with liver cirrhosis, depression, severe fatigue, and health limitations. Patients who achieved SVR12 had better outcomes on all PRO instruments. HCV-SIQv4 symptom and domain scores were responsive to improvements and worsening in health state (effect sizes ≥ 0.5). Thresholds for change in scores indicating a clinically important improvement (or worsening) were: 8 (8) for HCV-SIQv4 Overall Body System Score; 1 (1) for FSS; 3 (6) for CES-D; and 8 (worsening not studied) for EQ-5D-5L VAS. ConClusions: The FSS, CES-D, EQ-5D-5L, and HCV-SIQv4 are reliable, valid, and responsive measures of HCV treatment outcomes suitable for patients regardless of liver disease stage.