Varicella‐Zoster Virus Infection in Children with Underlying Human Immunodeficiency Virus Infection

Abstract

This article describes a prospective longitudinal study of varicella-zoster virus (VZV) infections in human immunodeficiency virus (HIV)-infected children, designed to determine their natural history of VZV infection and possible effects of VZV on the progression of HIV infection. Varicella was usually not a serious acute problem, and it did not seem to precede clinical deterioration. The rate of zoster was high: 70% in children with low levels of CD4+ lymphocytes at the time of development of varicella. It is predicted that immunization with live attenuated varicella vaccine is unlikely to be deleterious to HIV-infected children. Moreover, if they are immunized when they still have relatively normal levels of CD4+ lymphocytes, they may have a lower rate of reactivation of VZV than if they were allowed to develop natural varicella when their CD4+ cell counts have fallen to low levels as a result of progressive HIV infection.

Evaluation of Three Commercial Varicella-Zoster Virus IgG Enzyme-Linked Immunosorbent Assays in Comparison to the Fluorescent-Antibody-to-Membrane-Antigen Test

“…Thereafter, the virus can remain latent lifelong in trigeminal and dorsal root ganglia. Endogenous viral reactivation, thought to be associated with waning VZV-specific T-cell-mediated immunity (8), leads to herpes zoster, especially in older adults and immunocompromised persons. Seroepidemiological studies revealed that the prevalence of VZV-specific IgG class antibodies shows a rapid increase during the first decade of life and reaches more than 90% in developed countries (5,17,26).…”

Varicella zoster virus infection causing urinary retention in a child with HIV infection

“…Antiviral therapy decreases the duration and number of vesicles, but there is no evidence that it reduces the duration of neuropathic bladder dysfunction. 6,7 It is uncertain whether starting acyclovir therapy after the vesicles have formed alters the outcome.…”

“…Urine microscopy showed leukocytes <1 000 cells/mm³ and erythrocytes <1 000 cells/ mm³, and was negative for bacterial cultures. The patient's absolute CD4 count was 159×10 6 /l with a CD4% of lymphocytes of 9.42% and CD45 positive white cell count of 6.18×10 9 /l. Blood tests revealed 136 mmol/l sodium, 4.3 mmol/l potassium, 2.8 mmol/l urea, 32 µmol/l creatinine, a 5.9×10 9 /l white cell count, 11.5 g/dl haemoglobin and 303×10 9 /l platelets.…”

Oral Manifestations of Paediatric HIV Infection

“…Chronic VZV infection has been described in HIV-infected children and adults with low CD4+ counts. (Gershon et al, 1997;Morris et al, 1996;Ramos-Gomez et al, 1999).…”