The impact of varicella zoster virus: chronic pain.

Herpes zoster (HZ) is a common condition that affects all age groups and both immunocompetent and immunocompromised individuals. However, it mainly impacts elderly and immunocompromised people and is associated with important and sometimes permanent detriment to quality of life and activities of daily living. Age-related decline in cell-mediated immunity (CMI) permits reactivation of varicella zoster virus (VZV) from latency. The risk of developing post-herpetic neuralgia (PHN) can be predicted using epidemiologically identified risk factors, thus indicating which patients may benefit most from protection by appropriate means, including vaccination. Despite increasing knowledge of the pathology causing PHN, the management modalities for acute HZ pain and PHN remain inadequate. Public, and probably physician, understanding of HZ and its complications is poor, potentially leading to low utilisation of HZ vaccination and delayed presentation for treatment.