Incidence and risk of postherpetic neuralgia after varicella zoster virus infection in hematopoietic cell transplantation recipients: Hokkaido Hematology Study Group.

Abstract

To assess the incidence of and risk factors associated with postherpetic neuralgia (PHN) after hematopoietic cell transplantation (HCT) varicella zoster virus (VZV) infection, we conducted a retrospective chart review of 418 consecutive patients who underwent HCT between April 2005 and March 2007. The male/female ratio was 221/197, median age at HCT was 47 years (range: 0-69 years), and autologous/allogeneic/syngeneic HCT ratio was 154/263/1. Seventy-eight patients developed VZV infection after HCT. Sixty-two patients had localized zoster, 11 patients had disseminated zoster (rash like chicken pox), and 4 patients had visceral zoster. All cases were treated with acyclovir (ACV) or valacyclovir (VACV), and there was no VZV infection-related death. Twenty-seven (35%) of the 78 patients with VZV infection suffered PHN after resolution of VZV infection. Multivariate analysis showed that advanced age is the only risk factor in autologous HCT (P = .0075; odds ratio [OR] = 1.14; 95% confidence interval [CI], 0.97-1.33). On the other hand, advanced age (P = .0097; OR = 1.06; 95% CI, 1.01-1.12), male gender (P = .0055; OR = 12.7; 95% CI, 1.61-100.1), and graft-versus-host disease (GVHD) prophylaxis with a tacrolimus-based regimen (P = .0092; OR = 9.56; 95% CI, 1.44-63.3) were associated with increased risk of PHN in allogeneic HCT. This study for the first time clarified the risk of PHN in HCT recipients.

• Authors: Masahiro Onozawa, Satoshi Hashino, Yoshifumi Haseyama, Yasuo Hirayama, Susumu Iizuka, Tadao Ishida, Makoto Kaneda, Hajime Kobayashi, Ryoji Kobayashi, Kyuhei Koda, Mitsutoshi Kurosawa, Nobuo Masauji, Takuya Matsunaga, Akio Mori, Masaya Mukai, Mitsufumi Nishio, Satoshi Noto, Shuichi Ota, Hajime Sakai, Nobuhiro Suzuki, Tohru Takahashi, Junji Tanaka, Yoshihiro Torimoto, Makoto Yoshida, Takashi Fukuhara
• Journal: Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation (Biol Blood Marrow Transplant) Vol. 15 Issue 6 Pg. 724-9 (Jun 2009) ISSN: 1523-6536 [Electronic] United States
• PMID: 19450757 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Valine
• Valacyclovir
• Acyclovir

Topics

• Acyclovir (analogs & derivatives, therapeutic use)
• Adolescent
• Adult
• Aged
• Chickenpox (complications, prevention & control)
• Child
• Child, Preschool
• Female
• Genetic Diseases, Inborn (complications)
• Hematopoietic Stem Cell Transplantation
• Herpes Zoster (complications, prevention & control)
• Humans
• Incidence
• Infant
• Infant, Newborn
• Japan (epidemiology)
• Male
• Middle Aged
• Neoplasms (complications, surgery)
• Neuralgia, Postherpetic (epidemiology, etiology)
• Postoperative Complications (epidemiology, prevention & control)
• Retrospective Studies
• Risk
• Transplantation, Autologous
• Transplantation, Homologous
• Valacyclovir
• Valine (analogs & derivatives, therapeutic use)
• Virus Activation
• Young Adult