No evidence of family history as a risk factor for herpes zoster in patients with post‐herpetic neuralgia

Abstract

Little is known about reactivation of latent varicella zoster virus as herpes zoster in individuals with no underlying immunosuppression. Risk factors include age, sex, ethnicity, exogenous boosting of immunity from varicella contacts, underlying cell-mediated immune disorders, mechanical trauma, psychological stress, and immunotoxin exposure. An association between herpes zoster and family history of zoster has been proposed. A case-control study involving patients affected by post-herpetic neuralgia, which usually follows more severe acute herpes zoster, was performed. The patients with post-herpetic neuralgia were enrolled at the Pain Clinic of the Policlinico Tor Vergata in Rome, Italy, within 1 year from the onset of acute zoster. The controls matched for sex and age were chosen among healthy subjects without a history of herpes zoster presenting at the Internal Medicine Outpatient Clinic for hypertension in the same time period. All the participants in the study gave informed consent and were interviewed by medically trained and blinded investigators using a questionnaire. Similar proportions of the patients and the controls reported a family history of herpes zoster irrespective of the degree of relationship, i.e., 17.4% and 18.2%, respectively, by analyzing only the first-degree relatives [RR 1.03 (CI 95%: 0.78-1.37)], and 28.4% and 29.6%, respectively, by analyzing the total number of relatives [RR 1.03 (CI 95%: 0.81-1.31)]. Further and larger prospective cohort studies are needed to ascertain whether a family history of herpes zoster is really an independent predictor of zoster in different geographical settings.

One-year follow-up of patients with long-lasting post-herpetic neuralgia

“…Even considering the possibility of recall bias, which is inherent to any study in which subjects are asked to recall events that may have occurred months or even years before [16], the results of the present study clearly confirm previous observation that severity of disease on acute herpes zoster presentation and older age are the best indicators of developing post-herpetic neuralgia.…”

Herpes zoster: Family history and psychological stress—Case–control study

“…In their study, 39.3% of patients reported a family history of herpes zoster versus 10.5% of the controls, and a dose-dependent effect between single blood relative or multiple blood relatives with a history of herpes zoster was documented. 28 On the other hand, Gatti et al 29 did not identify family history as a risk factor for HZ, as cases and controls showed a similar percentage of family history of HZ. However, as stated by the authors, interpretation of their results was limited by the relatively low number of patients examined (173 cases and 176 controls), and the fact that the cases only included subjects affected by post-herpetic neuralgia who were older than 65 years.…”

Family history and herpes zoster risk in the era of shingles vaccination

“…8 The study involved Italian patients who presented with post-herpetic neuralgia (PHN) within one year of acute HZ. 28.4% of PHN cases reported a family history of HZ versus 29.6% of controls.…”