Zoster incidence in human immunodeficiency virus-infected hemophiliacs and homosexual men, 1984-1997

Eric A. Engels, Philip S. Rosenberg, Robert J. Biggar, Mitchell Gail, James J. Goedert, Thomas R. O'Brien, Charles Rabkin, Barbara L. Kroner, Susan L. Wilson, Louis M. Aledort, Stephanie Seremetes, M. Elaine Eyster, Donna Di Michele, Maragaret W. Hilgartner, B. Barbara Konkle, P. Phillip Blatt, Gilbert C. White, Alan R. Cohen, Anne L. Angiolillo, Naomi LubanCraig M. Kessler, Michael M. Lederman, Cindy Leissinger, Marilyn Manco-Johnson, W. Keith Hoots, Philippe De Moerloose, Angelos Hatzakis, A. Anastasia Karafoulidou, Titika Mandalaki, Wolfgang Schramm, Sabine Eichinger

Research output: Contribution to journalArticlepeer-review

51 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)1784-1789
Number of pages6
JournalJournal of Infectious Diseases
Volume180
Issue number6
DOIs
StatePublished - 1999

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