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 immunodeficienc y virus type 1 (HIV-1). Methods: Cases of VZV infection were identifie d 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 epi sodes 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 in fection, The majority of children (61%) had tester during the first re current episode, and 32% had a disseminated eruption typical of varice lla, There was a strong association between an increasing number of ep isodes of VZV infection and low CD4(+) cell count (p = 0.0008). In a s ubgroup followed for at least 2 years after their primary varicella ep isode, in of 22 children had a recurrence, Persistence of VZV infectio n was documented in in of 73 children, whereas other complications wer e rare, Thirty-three children (45%) were hospitalized and received acy clovir intravenously. Conclusion: Primary, recurrent, and persistent V ZV infections are a frequent cause of morbidity and hospitalization fo r HIV-1-infected children, Studies of improved preventive and therapeu tic agents are urgently needed in this population.