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Herpes zoster and HIV infection in Rwanda.
Harelimana F; Bugingo G; National University of Rwanda, Butare, Rwanda
December 30, 1990
Int Conf AIDS. 1990 Jun 20-23;6(1):234 (abstract no. Th.B.448). Unique

OBJECTIVE: To describe the clinical and epidemiological features of HIV related Herpes Zoster (HZ) in Rwanda, a country in Central Africa where the HIV infection and AIDS are common. METHODS: Between January 1985 and November 1989, 793 patients chosen from the Dermatology Clinic's attendants were screened for HIV1 antibodies. The relationship between HIV seropositivity and presentation with HZ was investigated by chart review of these patients. RESULTS: Of the 617 seropositive patients, 240 (39%) presented with HZ; 90% of all patients presenting with HZ were HIV seropositive. The average age was 30 years, 85% were between 21 and 40 years. All dermatomes were involved, specifically thoracic (45.2%), cervical (24.5%), lumbar (17.5%), cranial (11.4%), and sacral (1.3%). Only one patient, an eight year old child, had generalized involvement. Among 28 patients (11.6%) with HZ relapses, 23 had 2 HZ episodes, and 5 had 3. HZ was the first presenting sign of HIV infection in 149 patients (62%). At the first consultation, only 48 patients met the WHO Clinical Definition of AIDS in Africa (20%). The distribution according to sex, marital status, professional occupation and social environment followed the epidemiological profile of HIV infection in Africa. 17 patients are known to have died with a mean survival time of 3 years from the first episode of HZ. In the same Clinic, the HZ incidence has progesssively increased from 1985 (1.5%) to 1989 (3.5%). CONCLUSION: Among dermatological manifestations of HIV infection and AIDS, HZ is common and early manifestation. HZ could be used as a sentinel sign to measure the prevalence of HIV infection in a population such as the one reported above.