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 immunodeficiency virus type 1 (HIV-1). Methods: Cases of VZV infection were identified 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 episodes 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 infection, The majority of children (61%) had tester during the first recurrent episode, and 32% had a disseminated eruption typical of varicella, There was a strong association between an increasing number of episodes of VZV infection and low CD4(+) cell count (p = 0.0008). In a subgroup followed for at least 2 years after their primary varicella episode, in of 22 children had a recurrence, Persistence of VZV infection was documented in in of 73 children, whereas other complications were rare, Thirty-three children (45%) were hospitalized and received acyclovir intravenously. Conclusion: Primary, recurrent, and persistent VZV infections are a frequent cause of morbidity and hospitalization for HIV-1-infected children, Studies of improved preventive and therapeutic agents are urgently needed in this population.