[Varicella-zoster virus symptoms and polyneuropathy in a patient with human immunodeficiency virus infection not improved until highly active anti-retroviral therapy added to acyclovir therapy].
In March 2003, a 34-year-old man with left facial palsy, dysphagia, and hoarseness treated with acyclovir suffered worsened dermatological and neurological problems. A routine blood test in early April showed the patient to be HIV-antibody positive, so he was transferred to our hospital. Blood analysis showed serum HIV-RNA at 96,000 copies/mL and a CD 4 count of 170/microL. Brain MRI taken on admission showed a T 2 high lesion in their left medulla. Acyclovir was thought to be ineffective due to reduced cell-mediated immunity because of the HIV infection, and HAART therapy was begun. After two months of HAART, skin lesions and the T 2 high lesion in left medulla improred. HIV-RNA became undetectable and the CD 4 count exceeded 500/microL. Intracellular cytokine analysis by flow cytometry showed a shift from Th 2 to Th 1 dominance. The elimination of VZV may thus have been promoted by the combination of acyclovir and HAART.
Takeoka
Hiroaki
H
Department of Environmental Medicine and Infectoius Desease, Faculity of Medical Sciences, Kyushu University.
Chong
Yong
Y
Murata
Masayuki
M
Furusyo
Norihiro
N
Nabeshima
Shigeki
S
Yamaji
Kouzaburo
K
Kishihara
Yasuhiro
Y
Hayashi
Jun
J
D000212:Acyclovir / Q000008:administration & dosage*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D000998:Antiviral Agents / Q000008:administration & dosage*; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006562:Herpes Zoster / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D011115:Polyneuropathies / Q000150:complications* / Q000188:drug therapy
D000998:Antiviral Agents; D000212:Acyclovir