Shingles Research Today is a free monthly online journal that collates and summarizes the latest research about Shingles, including details on symptoms, treatment, causes, virus.

Improvement of postherpetic neuralgia after treatment with intravenous acyclovir followed by oral valacyclovir.

Quan D, Hammack BN, Kittelson J, Gilden DH

Department of Neurology, University of Colorado Health Sciences Center, Denver, Colorado 80262, USA.

BACKGROUND: Postherpetic neuralgia (PHN) is a complication of shingles (herpes zoster), a painful rash due to varicella-zoster virus reactivation. Studies of patients with PHN and zoster sine herpete (radicular pain without rash) support the notion that low-grade viral ganglionitis contributes to pain. If chronic pain reflects active infection, then antiviral therapy may help patients with PHN. OBJECTIVE: To determine whether antiviral treatment helps reduce PHN-associated pain. DESIGN: Prospective, open-label phase I/II clinical trial. SETTING: Tertiary care university hospital. PATIENTS: Fifteen patients with moderate to severe PHN. INTERVENTIONS: Intravenous acyclovir at a dosage of 10 mg/kg every 8 hours for 14 days followed by oral valacyclovir at a dosage of 1000 mg 3 times per day for 1 month. MAIN OUTCOME MEASURE: Numeric Rating Scale for Pain score. RESULTS: As defined by a decrease of 2 or more points on the Numeric Rating Scale for Pain, 8 (53%) of 15 patients reported improvement. CONCLUSION: Clinical improvement reported by most of our patients warrants further investigation in a larger, randomized, double-blind, placebo-controlled trial.

Published 11 July 2006 in Arch Neurol, 63(7): 940-2.
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