High incidence of herpes zoster in patients with AIDS soon after therapy with protease inhibitors

A high incidence of herpes tester 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 63 weeks (range, 34-103 weeks), 14 patients (7%) had a first episode or a recurrence of herpes tester (6.2 episodes per 100 patient-years). No episodes of tester were diagnosed before week 4. Twelve episodes (86%) occurred between weeks 4 and 16. The risk of tester 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 tester. These data might be clinically useful for determining transient prophylaxis for those patients at high risk.