CLINICAL SPECTRUM OF HERPES-ZOSTER IN ADULTS INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS

To determine the incidence and clinical manifestations of herpes tester in a hospital-based clinic for adults infected with human immunodeficiency virus (HIV), we reviewed the records of all patients for whom tester was diagnosed at or after their first clinic visit. Fifty-two episodes of tester occurred in 45 patients during 1,614 person-years of follow-up (incidence, 3.2 episodes per 100 person-years). The following major complications of tester occurred in 12 patients (27%): ocular complications (5), neurological complications (4), and chronic atypical skin lesions (5). Six patients each had postherpetic neuralgia and bacterial superinfection, which were the common minor complications of tester. Multivariate analysis revealed that only a low CD4 cell count (less than or equal to 200/mm(3)) was predictive of a major complication of tester (OR, 13.2; 95% CI, 1.52-114; P =.019). Thus, complications of herpes tester are common in patients with HIV infection, especially those with advanced immunosuppression.