Herpes Zoster ophthalmicus and HIV seropositivity in South-south Nigeria

Abstract

Herpes zoster is a painful vesiculobullous dermatitis which occurs as a result of previously established varicella zoster virus infection. It is a well
established fact that Herpes zoster ophthalmicus is a well known marker of human immune deficiency virus infection even in Africans. The aim of this study is to determine if indeed the herpes zoster condition is a marker for the immune deficiency condition called AIDS in our locality and whether the positivity is related to age or not. A total of 20 consecutive patients that
presented between 2003 and 2006 with herpes zoster ophthalmicus were examined retrospectively as to their Human Immune deficiency virus (HIV) status. Their presentation, clinical findings and clinical course are also
analyzed. Of the 20 patients examined, there was a male preponderance of 4:3 with most patients above 40 years (35.4% between 41-50 years) and half of them were married. Out of the twelve (n=12, 60%) patients whose serum was tested for human immunodeficiency virus, eight (n=8, 40%) were negative, while four (n=4, 20%) were positive for the virus .Eight were not tested. Using 40 years of age as the cutoff, those above 40 years (12 in number), two (n=2, 25%) were seropositive while 9
were negative (75%). For those below 40 years (8 in number), two (n=2, 25%) were positive while six were negative (75%).
Upon treatment with antivirals (Zovirax ) in the majority of cases there was complete resolution in 8 (57%) of the patients with most of the sequelae occurring in those of them who are seropositive.
Correlation of impaired immune status with Herpes zoster affectation was found to be more obvious in the younger than 40 years group.Treatment with antivirals gave good resolution in most cases. Blinding complications were found more in those who were seropositive.

Keywords: herpes zoster, HIV infection, Nigeria.