Zoster Incidence in Human Immunodeficiency Virus—Infected Hemophiliacs and Homosexual Men, 1984–1997

Zoster is an important clinical problem for human immunodeficiency virus type 1 (HIV)—infected patients. Risk factors for zoster and trends in incidence in HIV-infected hemophiliacs and homosexual men (n = 1218) were examined. From 1984 to 1997, 174 zoster cases were identified (average yearly incid...

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Bibliographic Details
Published in:The Journal of infectious diseases 1999-12, Vol.180 (6), p.1784-1789
Main Authors: Engels, Eric A., Rosenberg, Philip S., Biggar, Robert J.
Format: Article
Language:English
Subjects:
AIDS
Biological and medical sciences
Cohort studies
Epidemiology
Hemophilia
Herpes zoster
HIV
Human immunodeficiency virus
Human viral diseases
Infections
Infectious diseases
Major Articles
Male homosexuality
Medical sciences
Varicella zoster encephalitis
Varicella-zoster virus
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
Viruses
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Summary:Zoster is an important clinical problem for human immunodeficiency virus type 1 (HIV)—infected patients. Risk factors for zoster and trends in incidence in HIV-infected hemophiliacs and homosexual men (n = 1218) were examined. From 1984 to 1997, 174 zoster cases were identified (average yearly incidence, 2.5%). Prior zoster episodes were associated with increased risk for a subsequent episode (relative risk [RR], 4.30; 95% confidence interval [CI], 3.11–5.95). Among hemophiliacs, children and adolescents had the highest zoster risk, and zoster risk declined with age (RR, 0.80 per decade; 95% CI, 0.68–0.93). These findings suggest that HIV-infected persons do not produce or maintain adequate booster responses after varicella zoster virus exposure. Zoster risk was relatively constant when CD4 cell counts >200 cells/mm3 but increased steeply below this level. During the 14 years of follow-up, zoster incidence declined 9% per year. This trend occurred despite decreasing CD4 cell counts and was unexplained by zidovudine or acyclovir use.
ISSN:0022-1899
1537-6613
DOI:10.1086/315146