Frequent recurrence and persistence of varicella-zoster virus infections in children infected with human immunodeficiency virus type 1.
OBJECTIVE
To examine complications and treatment of varicella-zoster virus (VZV) infections in children infected with human immunodeficiency virus type 1 (HIV-1).


METHODS
Cases of VZV infection were identified retrospectively by reports to the department of health services and review of medical charts. The CD4+ cell counts were correlated with severity and frequency of VZV episodes.


RESULTS
We identified 117 episodes of VZV infection in 73 HIV-1-infected children between Aug. 21, 1986, and Dec. 1, 1993. The most common complications were recurrence and persistence; 38 children (53%) had 69 recurrent episodes of VZV infection. The majority of children (61%) had zoster during the first recurrent episode, and 32% had a disseminated eruption typical of varicella. There was a strong association between an increasing number of episodes of VZV infection and low CD4+ cell count (p = 0.0008). In a subgroup followed for at least 2 years after their primary varicella episode, 10 of 22 children had a recurrence. Persistence of VZV infection was documented in 10 of 73 children, whereas other complications were rare. Thirty-three children (45%) were hospitalized and received acyclovir intravenously.


CONCLUSIONS
Primary, recurrent, and persistent VZV infections are a frequent cause of morbidity and hospitalization for HIV-1-infected children. Studies of improved preventive and therapeutic agents are urgently needed in this population.
von Seidlein
L
L
Department of Pediatrics, University of California at Los Angeles, Childrens Hospital Los Angeles, USA.
Gillette
S G
SG
Bryson
Y
Y
Frederick
T
T
Mascola
L
L
Church
J
J
Brunell
P
P
Kovacs
A
A
Deveikis
A
A
Keller
M
M
D017088:AIDS-Related Opportunistic Infections / Q000276:immunology / Q000628:therapy / Q000821:virology*; D000293:Adolescent; D018791:CD4 Lymphocyte Count; D002644:Chickenpox / Q000276:immunology / Q000628:therapy / Q000821:virology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D012008:Recurrence