Herpes zoster and HIV-1 infection in a rural Ugandan cohort

Objective: To compare the rates and clinical features of herpes tester in HIV-positive and HIV-negative individuals in a cohort in rural Uganda; to report the incidence of herpes tester in the HIV-positive group in relation to seroconversion and CD4 cell counts and to determine whether it is indicative of a more rapid progression to death. Design: A prospective population-based cohort. Methods: The cohort comprised 107 prevalent and 144 incident (with documented dates of seroconversion) participants with HIV infection and 231 HIV-negative controls who were reviewed routinely every 3 months. Results: The mean rate of herpes tester was 53.6/1000 person-years in HIV-positive and 4.4 in HIV-negative participants. The cumulative incidence of a first episode of herpes tester was 7.6% at 2 years, 12.6% at 4 years and 24.0% at 6 years after seroconversion; the incidence rate was 35.6/1000 person-years. There was no evidence of a significant effect of age, gender, period from seroconversion or CD4 cell count on this incidence rate. Herpes tester was an indicator of HIV-1 infection in this population but not an indicator of more rapid progression to death after adjusting for CD4 cell count and age. Conclusions: The rates, including the cumulative incidence after seroconversion and the clinical presentation of herpes tester were similar to those reported from industrialized countries. Although an indicator of HIV-1 infection in this population, herpes tester was unrelated to CD4 cell count or period from seroconversion and did not lead to a faster disease progression. (C) 2001 Lippincott Williams & Wilkins.