Herpes zoster as an immune reconstitution disease after initiation of combination antiretroviral therapy in patients with human immunodeficiency virus type‐1 infection. (Hospital de la Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain) Am J Med. 2001;110:605–609.

Abstract

Of the 316 patients who initiated combination antiretroviral therapy, 24 were treated for herpes zoster within 17 weeks of starting therapy. The characteristics of these cases were compared with those of a control group of 96 human immunodeficiency virus type‐1 (HIV‐1) infected patients, who were matched by age, sex, plasma, HIV‐1 RNA concentration and CD4 cell counts, and length of follow‐up. The incidence of herpes zoster associated with combination antiretroviral therapy was 9 episodes per 100 patient years. There were no significant differences between cases and controls in age, sex, years of HIV infection, history of herpes zoster, previous acquired immune deficiency syndrome, or baseline mean CD4 and CD8 cell counts before beginning combination antiretroviral therapy. However, patients who developed herpes zoster had a significantly greater mean increase in the number of CD8 cells than did controls. Conclude that the initiation of combination antiretroviral therapy in HIV‐1 infected patients was often associated with the development of herpes zoster especially in those whom the number of CD8 cells increased after therapy.