Clinical spectrum of herpes zoster in HIV-infected versus non-HIV infected patients in Benin City, Nigeria

Abstract

Background: Herpes zoster is due to reactivation of the varicella-zoster virus (VZV) at the sensory nerve ganglia. Some reports indicate that there might be differences in the pattern of presentation of herpes zoster in HIV infected patients. The objective of this study therefore, is to compare the clinical spectrum of herpes zoster in HIV-infected versus non-HIV infected patients. Study design: In this prospective study all patients presenting with clinical features of Herpes zoster had serological test (ELISA) for Human immunodeficiency viral (HIV) antibodies done and confirmed by the Double/Triple test algorithm. They were examined clinically to determine the dermatome(s) involved, the severity of the disease and the presence of any complication. The patients were categorized according to their HIV-status for the purpose of statistical analysis. Results: Fifty-two out of the seventy-three patients seen during the study period were evaluated: 22 male (42.3%) and 30 female (57.7%) patients. Thirty-six (69.2%) patients were HIV-positive while 16 (30.8%) were HIV-negative. The age distribution of the patients was bimodal; the mean age of patients in the HIV-positive group was 36.1 ± 16.14 years while that of the HIV-negative group was 56.3±17.51 years. Multidermatomal involvement, affectation of the Trigeminal nerve dermatome and the presence of systemic symptoms such as fever and weakness correlated significantly with the presence of HIV infection. Mean times to cessation of new vesicle formation, crusting, and resolution of zoster-associated pain were also significantly longer in the HIV-positive patients. There were no statistically significant differences in the incidence of post-herpetic neuralgia, keloids, and bacterial super-infection in both groups. Conclusion: Herpes zoster was generally more severe in the presence of HIV infection.