HERPES-ZOSTER IN PATIENTS WITH ADVANCED HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION TREATED WITH ZIDOVUDINE

To determine the prevalence, incidence, and effects on disease progres sion and survival of herpes zoster in patients with advanced human imm unodeficiency virus (HIV) disease, data from a multicenter observation al cohort study of 1044 patients with AIDS or AIDS-related complex (AR C) and CD4 cell count less-than-or-equal-to 0.25 x 10(9)/L treated wit h zidovudine were analyzed. Of 163 patients (16%) with a history of he rpes zoster at enrollment, 22 (13%) had a recurrence during the 2-year follow-up. For those without prior herpes zoster, the probability of its development was 6.3% at 1 and 8.8% at 2 years. Progression to AIDS was not associated with herpes zoster. By proportional hazards analys is, an initial occurrence of herpes zoster was associated with prolong ed survival independent of baseline CD4 cell count and disease stage; however, recurrence tended to be associated with death. Thus, herpes z oster is relatively common in advanced HIV infection and its initial o ccurrence late in disease may indicate improved prognosis.