High Incidence of Herpes Zoster in Patients with AIDS Soon After Therapy with Protease Inhibitors

• Published in: Clinical infectious diseases Vol. 27; no. 6; pp. 1510 - 1513
• Main Authors: Martínez, Esteban, Gatell, José, Morán, Yolanda, Aznar, Esther, Buira, Elisabet, Guelar, Ana, Mallolas, José, Soriano, Eladio
• Format: Journal Article
• Language: English
• Published: United States The University of Chicago Press 01.12.1998; University of Chicago Press
• Subjects: Acquired Immunodeficiency Syndrome - drug therapy; Acquired Immunodeficiency Syndrome - immunology; Adult; AIDS; AIDS-Related Opportunistic Infections - chemically induced; AIDS-Related Opportunistic Infections - immunology; AIDS-Related Opportunistic Infections - mortality; AIDS-Related Opportunistic Infections - virology; CD4 Lymphocyte Count; CD8-Positive T-Lymphocytes - immunology; Female; Herpes zoster; Herpes Zoster - chemically induced; Herpes Zoster - complications; Herpes Zoster - epidemiology; Herpes Zoster - mortality; HIV 1; Human immunodeficiency virus 1; Humans; Infections; Lymphocytes; Male; Memory interference; Middle Aged; Prospective Studies; Protease inhibitors; Protease Inhibitors - adverse effects; Protease Inhibitors - therapeutic use; Survival Rate; T tests; Varicella-zoster virus 1; Viral load; Viruses
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/515019

A high incidence of herpes zoster was noticed among patients with AIDS, shortly after addition of a protease inhibitor to their baseline treatment with nucleoside analogue reverse-transcriptase inhibitors. Within a median follow-up of 64 weeks (range, 34–103 weeks), 14 patients (7%) had a first episode or a recurrence of herpes zoster (6.2 episodes per 100 patient-years). No episodes of zoster were diagnosed before week 4. Twelve episodes (86%) occurred between weeks 4 and 16. The risk of zoster was independent of age, sex, type of protease inhibitor, and CD4+ lymphocyte count and viral load at baseline and month 1. A CD8+ lymphocyte proportion at baseline of >66% (hazard ratio [HR], 10.6; 95% confidence interval [CI], 3.4–33.1) and an increase in CD8+ lymphocyte proportion at month 1 of >5% (HR, 32; 95% CI, 8.1–126.4) were independently associated with the risk of herpes zoster. These data might be clinically useful for determining transient prophylaxis for those patients at high risk.