Herpes zoster and progression to AIDS in a cohort of HIV seroconverters

A prospective study of 1,198 individuals who seroconverted to human immunodeficiency virus (HIV) was conducted to estimate the incidence and determinants of herpes zoster and to determine whether herpes zoster can accelerate the progression to AIDS. Herpes zoster was diagnosed for 48 individuals (4%). After adjusting for the CD4 cell count, individuals acquiring HIV infection through sexual contact were more likely to have herpes zoster than were injection drug users (relative hazard, 1.50). The crude relative hazard of AIDS for individuals who had herpes zoster compared with those without herpes zoster was 2.44; the adjusted relative hazard was 1.08. After adjusting for the CD4 cell count, fever was the only specific characteristic of herpes zoster that was significantly associated with a more rapid progression to AIDS (relative hazard, 6.52). Data suggest that herpes zoster occurs more frequently in individuals acquiring HIV infection through sexual transmission. There was no evidence that herpes zoster per se is an independent cofactor of progression of HIV disease, although febrile episodes of herpes zoster may predict a faster progression to AIDS