EFFECT OF ORAL ACYCLOVIR ON PAIN RESOLUTION IN HERPES-ZOSTER - A REANALYSIS

The most frequent complication of herpes zoster is postherpetic neural gia, usually defined as chronic pain in the area of the exanthem that persists for at least a month after the skin lesions have healed. Seve ral clinical studies of acyclovir showed a reduction in severity and d uration of acute pain, but provided no definitive data for chronic pai n. In order to determine if acyclovir therapy could reduce chronic pai n, we reanalyzed data from the largest U.S. placebo-controlled treatme nt trial of 187 immunocompetent persons with herpes zoster. By conside ring pain as a continuum, we found that the median duration of pain in acyclovir recipients was 20 days vs. 62 days for their placebo counte rparts (P = 0.02). Thus, acyclovir has been shown to reduce chronic zo ster-associated pain. We also noted that the absence of pain at the on set of cutaneous herpes zoster did not preclude its later development. (C) 1993 Wiley-Liss, Inc.