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Ask the Experts about Opportunistic Infections

 

Shingles/Chicken Pox & HIV+
Jan 13, 2002

I am HIV+ with good CD4 (800) and low VL (6000). I am NOT currently on meds.

I had a sexual encounter recently (1 month ago), and noticed a nasty rash across the front of my partners chest- and I mean NASTY. It hurt to look at.

He said that it was Shingles but that it was not contagious. (I have heard otherwise)

My questions(s):

1. Is it contagious?

2. I never had the chicken pox. Either I'm immune to it, or was never exposed to it. Are CP & Shingles related?

3. Will I now get Shingles?

4. Should I get the vaccination for Chicken Pox?

Please answer... I'm scared to death. I have heard terrible things about this....

Response from Dr. Feinberg

It was less than wise of you to be intimate with someone with an obvious medical problem. That said, here are the facts about shingles and chicken pox:

Shingles is merely reactivated chicken pox. That means in order to have an outbreak of shingles, you had to have been infected with chicken pox in the past, typically in childhood. Even people with no memory of having had chicken pox may have evidence of prior infection via a blood test, either because the infection was so mild it went unnoticed, or because memories are faulty. Exposure to chicken pox is common, and more than 90% of adults have a positive blood test for past exposure. So even you you don't remember having chicken pox, you may have had it.

But shingles IS contagious-- your partner was wrong. If you are among the small minority of adults who have truly never had chicken pox, then if you are exposed to someone with shingles and you catch the virus, then you will come down with chicken pox (but not with shingles, since this would be your first contact with the infection).

In your case, since the exposure was a month ago, then you're no longer at risk for getting chicken pox. You either got lucky, or you've been infected with the chicken pox virus (Varicella zoster virus) in the past. People exposed to VZV who get infected will develop chicken pox almost exactly 14 days later. So the best thing to do now is to ask your doctor to do the blood test ("VZV IgG") so you know whether you're at future risk or not.



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