Age-sex interaction on the development of postherpetic neuralgia among shingles patients with moderate and severe pain levels

Abstract

Background: Herpes zoster (HZ), commonly known as shingles, can lead to postherpetic neuralgia (PHN), a chronic neuropathic pain condition that significantly impacts patients’ quality of life. Age is a well-established risk factor for PHN, with incidence increasing among older individuals. However, the role of sex in PHN development remains unclear, with conflicting evidence regarding its influence. This study investigates the interaction between age, sex, and PHN risk among shingles patients with moderate to severe pain levels.

Methods: A retrospective cohort study was conducted using electronic medical records from hospitalized HZ patients between 2018 and 2021. PHN was defined as persistent pain lasting ≥3 months post-HZ onset. Statistical analyses, including logistic regression and generalized additive models, were employed to assess risk factors.

Results: Results showed that age was a significant predictor of PHN, particularly among patients with moderate to severe pain. In male patients, PHN risk increased linearly with age, whereas in female patients, a nonlinear relationship was observed, with a peak in risk between 60 and 70 years. Pain severity and comorbidities were also associated with PHN development. The observed sex differences may be influenced by variations in pain perception and healthcare-seeking behaviors, with older women receiving antiviral treatment earlier.

Conclusion: These findings highlight the importance of considering age-sex interactions when assessing PHN risk. Early intervention, particularly in patients experiencing severe acute pain, may help mitigate PHN development. Further research is needed to refine targeted prevention strategies.