Question

Hello Dr. Joseph, I have three questions :1-Is Herpes Zoster considered as an HIV-related opportunistic infection? 2- Does having frequent recurrence of Herpes Zoster means for sure HIV infection? ( I do have Zoster for 1 year now I am 29 years old male, I had some unprotected vaginal intercourse before 3 years, my HIV test was done after 2 years of my last risky exposure and it was Negative). 3- Do you think that I need a PCR test because ( I guess ) I might be having problem in producing antibodies? I have met many people who have the same problem as mine and they assured me that there is nothing to worry about but I do WORRY , please help me Dr. I need your advice.

Answer

Sorry to hear that you have suffered from herpes zoster (also known as shingles).

Although zoster is more likely to occur in people with HIV it is not a condition that indicates AIDS. People without HIV infection also get zoster, and having zoster does not mean that a person is infected with HIV, even if they have had recurrent episodes.

Since your HIV test has been negative 24 months after an exposure you are very unlikley to be infected with HIV. You should be sure to see a physician to make sure that you are having recurrent zoster and not just "post-herpetic neuralgia" which is a condition in which the skin involved with zoster can remain painful for months (or longer). The skin can be permanently scarred after a zoster outbreak as well. If you are truly having relapses of zoster then suppressive therapy may be indicated and a workup for other causes of immune deficiency would be of value.

Best,

Joe