Abstract: Objective: To preliminarily investigate the correlation between the inflammation-immunity-nutrition score (IINS) and the severity of postherpetic neuralgia (PHN) in patients with acute herpes zoster (HZ). Methods: Clinical data were retrospectively collected from 305 HZ patients treated in our hospital between August 2022 and August 2025. Patients were divided into a PHN group (n = 82) and a non-PHN group (n = 223) based on the occurrence of PHN. A control group of 194 healthy individuals undergoing routine physical examinations during the same period was included. Spearman correlation analysis was conducted to assess the relationship between acute-phase IINS and PHN severity. A logistic regression model was developed, and ROC curves were plotted to analyze the value of the IINS in assessing the risk of PHN. Results: Patients in the PHN group demonstrated significantly higher acute-phase visual analog scale (VAS) scores, higher C-reactive protein levels at admission, a higher proportion of cases with onset-to-treatment time ＞ 3 days, and a higher proportion of gangrenous/hemorrhagic HZ compared to the non-PHN group. Lymphocyte and albumin levels were lower in the PHN group than in the non-PHN group and the control group (all P＜ 0.05). PHN patients exhibited higher IINS than the non-PHN group and the control group (P＜0.05). In PHN patients, IINS had moderate positive correlations with pain index, pain intensity, and VAS scores (P＜0.05). Elevated IINS (OR: 7.262) constituted an independent risk factor for PHN (all P＜0.05). The AUC of IINS for predicting PHN was 0.845, demonstrating significantly superior predictive performance compared to S100β and neuron-specific enolase (all P＜0.05). The combined assay of the three parameters yielded an AUC of 0.934. Conclusion: The IINS score is moderately positively correlated with pain severity in PHN patients and can serve as an effective indicator for early risk assessment of PHN. Combined detection with S100β and NSE can further improve predictive accuracy, providing a basis for early clinical intervention.

Key words: herpes zoster, inflammation-immunity-nutrition score, postherpetic neuralgia, pain severity