Shingles in HIV: Outcome and discovery

Area of Science:

• Infectious Diseases
• Dermatology
• Immunology

Background:

• Herpes zoster (HZ) incidence is significantly higher in people living with HIV (PLHIV) compared to the general population.
• HZ often serves as an early indicator of immunosuppression in PLHIV, necessitating prompt diagnosis and treatment.
• Understanding HZ in PLHIV is critical for managing opportunistic infections and HIV progression.

Purpose of the Study:

• To analyze the clinical characteristics and outcomes of Herpes zoster (HZ) in people living with HIV (PLHIV).
• To highlight the role of HZ as a sentinel sign for undiagnosed HIV infection.
• To evaluate the effectiveness of current management strategies for HZ in PLHIV.

Main Methods:

• Retrospective analysis of 45 PLHIV diagnosed with HZ between January 2015 and September 2024.
• Data collection included patient demographics, antiretroviral therapy (ART) status, HZ presentation, and treatment outcomes.
• Patients were recruited from Infectious Diseases and Dermatology departments.

Main Results:

• The mean age of patients was 36.35 years, with a male predominance.
• Twelve patients had undiagnosed HIV, with HZ being the presenting symptom.
• Thoracic HZ was most common; treatment included acyclovir, with hospitalization for severe cases.

Conclusions:

• Herpes zoster (HZ) remains a significant opportunistic infection and a potential sentinel sign for undiagnosed HIV.
• Early HIV screening in HZ patients and prompt antiviral therapy are essential for improved clinical outcomes.
• Integrated management strategies and increased awareness are vital for addressing HZ in PLHIV.