Journal Article

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

Esteban Martínez, José Gatell, Yolanda Morán, Esther Aznar, Elisabet Buira, Ana Guelar, José Mallolas and Eladio Soriano

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 6, pages 1510-1513
Published in print December 1998 | ISSN: 1058-4838
Published online December 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515019
High Incidence of Herpes Zoster in Patients with AIDS Soon After Therapy with Protease Inhibitors

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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.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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