BACKGROUND: Herpes zoster occurs at all CD4 cell counts in HIV-infected adults. It was hypothesized that even in the era of highly active antiretroviral therapy (HAART), zoster risk is higher in HIV-infected than uninfected women. METHODS: Generalized estimating equations modeled self-reported occurrence of zoster between semiannual visits among 1832 HIV-infected and 489 HIV-uninfected women in the Women's Interagency HIV Study followed for up to 7.5 years. RESULTS: A total of 337 (18.4%) HIV-infected and 7 (1.4%) HIV-uninfected women reported zoster at some time during follow-up. Using HIV-infected women with CD4 >750 cells/microL as the reference category, the odds ratios for reporting zoster since the prior visit were: 1.43 (95% CI 0.86-2.37) for CD4 500-749 cells/microL, 2.07 (95% CI 1.27-3.38) for CD4 350-499 cells/microL, 2.72 (95% CI 1.66-4.46) for CD4 200-349 cells/microL, and 3.16 (95% CI 1.92-5.18) for CD4 <200 cells/microL, compared with 0.11 (95% CI 0.046-0.26) for HIV-uninfected women. In multivariate analyses using visits from all HIV-infected women and only those who initiated HAART, lower CD4 cell count was more strongly associated with zoster incidence than were other clinical indicators. CONCLUSIONS: Herpes zoster is associated with degree of immunosuppression in HIV-infected women, but even women with high CD4 counts are at greater risk of zoster than HIV-uninfected women.
BACKGROUND: Herpes zoster occurs at all CD4 cell counts in HIV-infected adults. It was hypothesized that even in the era of highly active antiretroviral therapy (HAART), zoster risk is higher in HIV-infected than uninfected women. METHODS: Generalized estimating equations modeled self-reported occurrence of zoster between semiannual visits among 1832 HIV-infected and 489 HIV-uninfectedwomen in the Women's Interagency HIV Study followed for up to 7.5 years. RESULTS: A total of 337 (18.4%) HIV-infected and 7 (1.4%) HIV-uninfectedwomen reported zoster at some time during follow-up. Using HIV-infectedwomen with CD4 >750 cells/microL as the reference category, the odds ratios for reporting zoster since the prior visit were: 1.43 (95% CI 0.86-2.37) for CD4 500-749 cells/microL, 2.07 (95% CI 1.27-3.38) for CD4 350-499 cells/microL, 2.72 (95% CI 1.66-4.46) for CD4 200-349 cells/microL, and 3.16 (95% CI 1.92-5.18) for CD4 <200 cells/microL, compared with 0.11 (95% CI 0.046-0.26) for HIV-uninfectedwomen. In multivariate analyses using visits from all HIV-infectedwomen and only those who initiated HAART, lower CD4 cell count was more strongly associated with zoster incidence than were other clinical indicators. CONCLUSIONS: Herpes zoster is associated with degree of immunosuppression in HIV-infectedwomen, but even women with high CD4 counts are at greater risk of zoster than HIV-uninfectedwomen.
Authors: Kate Shearer; Mhairi Maskew; Toyin Ajayi; Rebecca Berhanu; Pappie Majuba; Ian Sanne; Matthew P Fox Journal: Int J Infect Dis Date: 2014-03-25 Impact factor: 3.623
Authors: Marius Birlea; Gabriele Arendt; Eser Orhan; D Scott Schmid; William J Bellini; Christian Schmidt; Don Gilden; Randall J Cohrs Journal: J Neurol Sci Date: 2011-03-17 Impact factor: 3.181
Authors: Alexander C Ewing; Sascha R Ellington; Jeffrey B Wiener; Charles S Chasela; Gerald Tegha; Julie A E Nelson; Denise J Jamieson; Charles van der Horst; Athena P Kourtis Journal: Pediatr Infect Dis J Date: 2019-05 Impact factor: 2.129