Journal of NeuroVirology

, Volume 25, Issue 1, pp 91–100 | Cite as

Herpes zoster increased risk of neuralgic amyotrophy: a retrospective, population-based matched cohort study

  • Tsung-Yen Ho
  • Chi-Hsiang Chung
  • Yu-Ping Shen
  • Liang-Cheng Chen
  • Wu-Chien ChienEmail author
  • Yung-Tsan WuEmail author


Although neuralgic amyotrophy (NA) has occasionally been reported to be associated with reactivated herpes zoster, their associated risk remains unknown. The aim of this study was to assess the risk of developing NA following preceding herpes zoster. The authors used the National Health Insurance Research Database of Taiwan to select 41,548 patients with newly diagnosed herpes zoster during the period 2000 to 2010 and randomly extracted 166,192 matched control subjects. All participants in the study and control groups were followed for 3 months after the diagnosis to identify those who developed NA. Cox proportional hazards regression analyses were performed to evaluate the subsequent risk of NA. Twenty-one subjects from the group with herpes zoster (0.05%) developed NA over the 3-month period and 46 from the group without herpes zoster (0.03%). The patients with herpes zoster had a higher risk of developing NA (adjusted hazard ratio = 1.408, 95% confidence interval = 1.013–2.319, P = 0.030). In the patients with herpes zoster, female sex, age ≥ 65, hepatitis E virus (HEV), and having had a recent infectious event including pneumonia and influenza were risk factors for developing NA (adjusted HR 2.746, 1.998, 2.735, 2.016, and 1.718, respectively, all P < 0.05). Patients with herpes zoster attack have a higher risk of developing NA over a 3-month period after diagnosis, especially those who are female, age ≥ 65, HEV, or have experienced a recent infectious event or pneumonia and influenza.


Herpes zoster Neuralgic amytrophy Taiwan Hazard ratio Hepatitis E virus 


Funding information

This study was funded by Tri-Service General Hospital Research Foundation (TSGH-C107-004). The funder has no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Compliance with ethical standards

Research ethics

All authors claim that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. The Institutional Review Board of Tri-Service General Hospital approved this study (TSGHIRB No.2-105-05-082).

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Journal of NeuroVirology, Inc. 2018

Authors and Affiliations

  • Tsung-Yen Ho
    • 1
  • Chi-Hsiang Chung
    • 2
    • 3
    • 4
  • Yu-Ping Shen
    • 1
  • Liang-Cheng Chen
    • 1
  • Wu-Chien Chien
    • 2
    • 4
    • 5
    Email author
  • Yung-Tsan Wu
    • 1
    Email author
  1. 1.Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of MedicineNational Defense Medical CenterTaipeiRepublic of China
  2. 2.School of Public HealthNational Defense Medical CenterTaipeiTaiwan
  3. 3.Taiwanese Injury Prevention and Safety Promotion Association (TIPSPA)TaipeiTaiwan
  4. 4.Department of Medical Research, Tri-Service General HospitalNational Defense Medical CenterTaipeiRepublic of China
  5. 5.Graduate Institute of Life SciencesNational Defense Medical CenterTaipeiTaiwan

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