Complications and Antiviral Strategies in Herpes Zoster: A Retrospective Evaluation of 50 Patients Treated in a Secondary Care Setting.

Purpose: To evaluate clinical characteristics, antiviral treatment patterns, complication rates, and the role of vitamin B12 supplementation among patients with herpes zoster (HZ) managed in a secondary care setting. Patients and Methods: Fifty adults with clinically diagnosed HZ (July 2019-October 2020) were included. Demographics, comorbidities, dermatomal involvement, laboratory findings, antiviral therapy (acyclovir, valacyclovir, brivudine), vitamin B12 use, and complications were recorded. Patients were stratified by age (<65 vs ≥65 years). Categorical variables were compared using chi-square or Fisher's exact test, and continuous variables with Results: The mean age was 63 ± 16 years, and 58% of patients were female. Diabetes and hypertension were the most common comorbidities. All patients received antiviral therapy within 72 hours of symptom onset. Postherpetic neuralgia (PHN) occurred in 8% of patients, and 2% developed secondary bacterial infection. Complication rates were 0% with acyclovir, 5.3% with valacyclovir, and 21.1% with brivudine (p = 0.112). No statistically significant difference in complication rates was observed between patients who received vitamin B12 and those who did not (p = 1.00). Complications occurred more frequently in patients aged ≥65 years compared with those <65 years (16% vs 4%; p = 0.35). ALT levels were significantly lower in patients aged ≥65 years (p = 0.015). Conclusion: Early antiviral therapy was associated with a low incidence of PHN. Although brivudine was associated with a higher complication rate, causality cannot be established. The role of vitamin B12 remains uncertain. Larger prospective studies are warranted.