American Journal of Clinical Dermatology

, Volume 6, Issue 5, pp 317–325 | Cite as

Current Management of Herpes Zoster

The European View
  • Antonio VolpiEmail author
  • Gerd Gross
  • Jana Hercogova
  • Robert W. Johnson
Review Article


The overall incidence of herpes zoster in Europe is approximately 3 per 1000 people per year and more than 10 per 1000 people per year in those aged >80 years. Post herpetic neuralgia (PHN) is a common debilitating complication of herpes zoster, particularly in patients aged >50 years, in persons with severe pain or rash at presentation, and in those with significant prodromal symptoms.

Antiviral drugs can effectively control acute symptoms and, if used early enough in the course of the illness, can help prevent the development of PHN and other complications. However, despite this, many patients do not receive such treatment. The economic impact of zoster and PHN is largely underestimated in Europe. Furthermore, there is considerable variation throughout Europe in the management of herpes zoster. Use of antiviral therapy including the newer potent antiviral agents such as brivudin, which requires less frequent administration than acyclovir, is improving patient outcomes in some European countries. However, in many countries, patient awareness of herpes zoster and, as a result, overall antiviral use is low.

Guidelines recommending the use of antiviral agents, particularly in patients at risk of developing PHN, are available but are not widely used. More needs to be done to educate the general public and increase awareness among primary healthcare providers of the benefits of timely and appropriate pharmacological therapy in patients with herpes zoster.


Herpes Zoster Acyclovir Antiviral Therapy Varicella Zoster Virus Post Herpetic Neuralgia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This manuscript was supported by an educational grant from Menarini, Italy and was prepared with editorial assistance by Mary Hines, Wolters Kluwer Health.

Antonio Volpi has undertaken educational or consultancy activities with Menarini, GlaxoSmithKline, Allen, Novartis, and Guidotti. Gerd Gross and Jana Hercogova have received assistance from and have undertaken educational or consultancy activities with Menarini. Robert W. Johnson has undertaken educational or consultancy activities with Menarini, Novartis, GlaxoSmithKline, Merck, Reliant and Yamanouchi.


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Copyright information

© Adis Data Information BV 2005

Authors and Affiliations

  • Antonio Volpi
    • 1
    Email author
  • Gerd Gross
    • 2
  • Jana Hercogova
    • 3
  • Robert W. Johnson
    • 4
  1. 1.Department of Public HealthUniversity of RomeRomeItaly
  2. 2.Department of Dermatology and VenereologyUniversity of RostockRostockGermany
  3. 3.Department of Dermatology and VenereologyCharles UniversityPragueCzech Republic
  4. 4.Pain Management Clinic, Bristol Royal InfirmaryUniversity of BristolBristolUK

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