Herpes zoster: a common disease that can have a devastating impact on patients' quality of life

Medical advances have markedly increased human longevity, but this longer life comes at a price; older people often suffer from greater morbidities that severely impact their day-to-day ability to function normally. However, there is a growing commitment from the medical community to add 'quality' to the extra years that people live. An important question in this regard is: how do we impact usual aging, with its attendant higher risks of disease and turn it into successful aging and independency? That is the focus of this review, which looks at herpes zoster (HZ), a condition that is both common and causes severe complications in the elderly. Even with appropriate treatment, HZ can have a significant negative impact on the patient's quality of life. A previously active individual can be severely affected by the disease and its complications such as postherpetic neuralgia. Clinical management, at best, produces modest benefit (for a variety of reasons including a delay in providing treatment, ineffective drugs chosen, poor tolerability and drug-drug interactions). We then find ourselves in the position of trying to treat a patient who is losing confidence in the options available to them, and who is slowly becoming less active and, if we are not careful, more frail and with the increasing likelihood of requiring long-term care. Both the personal and societal burden of HZ and postherpetic neuralgia are therefore considerable, and this highlights the need for better preventative and treatment strategies.