Contact with varicella-zoster virus (VZV) is nearly universal in the United States, manifesting disease as varicella (primary infection) and herpes zoster (secondary or reactivated infection). Greater than 90% of adults in the United States show serologic evidence of previous VZV exposure. Prior to the acquired immunodeficiency syndrome (AIDS), there were an estimated three million cases of varicella and 1.5 million cases of zoster occurring annually in the United States. In 1983, VZV disease was first recognized in the context of infection with the human immunodeficiency virus (HIV). Since that time, there have been many reports on the occurrence and clinical manifestations of herpes zoster in HIV-infected patients and, more recently, the occurrence of primary varicella in such patients. In this issue of the Archives,1-3 three reports describe various aspects of VZV disease in the context of HIV infection.
Prior to AIDS, the annual incidence of herpes zoster in the general population was about
Gulick RM, Heath-Chiozzi M, Crumpacker CS. Varicella-Zoster Virus Disease in Patients With Human Immunodeficiency Virus Infection. Arch Dermatol. 1990;126(8):1086-1088. doi:10.1001/archderm.1990.01670320110022