Association of the incidence of postherpetic neuralgia with early treatment intervention of herpes zoster and patient baseline characteristics: A systematic review and meta-analysis of cohort studies

Objectives: To conduct a meta-analysis of the association between postherpetic neuralgia (PHN), baseline characteristics of patients with herpes zoster (HZ), and early interventions. Methods: Literature searches were conducted in seven databases, in June 2021 and updated in June 2022. Two investigators independently conducted literature screening and data extraction, and the studies were evaluated according to the Newcastle-Ottawa scale. Results: A total of 53 cohort studies were included. The meta-analyses identified skin lesions, timing of initial treatment ( >= 3 days), and comorbidities as potential risk factors for PHN. In contrast, female sex (odds ratio [OR] = 1.13, 95% confidence interval [CI]: 0.99-1.29), cervical herpes (OR = 0.80, 95% CI: 0.212.99), lumbar herpes (OR = 1.29, 95% CI: 0.61-2.74), and immunosuppressive therapy (OR = 1.96, 95% CI: 0.22-17.12), were not significantly associated with PHN. In addition, glucocorticoid use (OR = 0.61, 95% CI: 0.22-1.70) may be a protective factor for the development of PHN; however, the difference was not statistically significant. Conclusion: A series of baseline characteristics were identified among populations at high risk of developing PHN from HZ. Additionally, the timing of initial treatment is associated with PHN occurrence. The preventive effect of glucocorticoids warrants further validation. (c) 2024 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )