Table of ContentsView AllTable of ContentsWhat Is Shingles?Risk of ComplicationsTreatmentImmune Reconstitution Inflammatory Syndrome (IRIS)
Table of ContentsView All
View All
Table of Contents
What Is Shingles?
Risk of Complications
Treatment
Immune Reconstitution Inflammatory Syndrome (IRIS)
Research indicates thatshinglesmay actually be an early sign of human immunodeficiency virus (HIV).HIV is also associated with a more severe case of shingles, in addition to other complications like long-lasting pain. In this article, we’ll discuss the connection between HIV and shingles.
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Shingles, also known as herpes zoster, is a condition that develops in people who have hadchickenpox. After someone gets chickenpox, typically during childhood, the virus lies dormant in the nerves. Later on, the virus can reactivate and cause shingles.
Shingles may indicate a weakened immune system since the body can usually keep the virus from reactivating. Thus, the fact that it is triggered at all may be a sign of a weakened immune system response.
Sometimes shingles can also lead toherpes zoster ophthalmicus(HZO). This occurs when varicella-zoster is reactivated in the nerves in the eye area. Almost 8% of people with herpes zoster will develop HZO.However, people with HIV have the greatest risk of developing HZO compared with the general population.
Symptoms of Shingles
Besides a rash, some other symptoms associated with shingles include:
The shingles rash is made up of blisters that will most likely scab over within seven to 10 days, fully clearing up within two to four weeks.
What Does Shingles Feel Like?
What Is the Connection to HIV?
People with HIV have been found to have higher rates of shingles than the general population.They are also at risk of experiencing complications as a result of shingles.
While shingles can be triggered in adults with HIV at any CD4 count, the risk of infection is higher in people with lowered CD4 counts, as in less that 200 cells per cubic millimeter of blood (cells/mm3).
Lowered CD4 counts are linked to untreated HIV and stage 3 (advanced) HIV, which is also called AIDS. This is why shingles may indicate HIV since untreated HIV and stage 3 HIV are associated with a higher chance of developing shingles.
A person with a compromised immune system is more susceptible to getting shingles. This includes people with untreated HIV and stage 3 HIV. This may have to do with depleted levels of CD4 cells, meaning the body is more vulnerable to infection.
People with HIV are more at risk of shingles-related complications.These may include:
Certain factors will further increase your risk of developing complications from shingles if you have HIV. These include:
People with HIV who get shingles typically need specific treatment. In some cases, hospitalization may be necessary. As far as specific therapies go, the following are recommended for people with HIV and shingles:
If someone has acyclovir-resistant shingles, Foscarnet administered intravenously (IV), through a vein, is effective.
When it comes to the varicella vaccine, it can be given to people who have HIV and CD4 cell counts of greater than 200 cells/µL, even though there is a theoretical risk of live virus vaccination in this population. Although it should be noted that a live vaccine to prevent the reactivation of the varicella-zoster virus is not recommended for immunocompromised patients, including people with HIV.However, there is a new, recombinant non-live virus sub-unit herpes zoster vaccine known as Shingrix. This particular vaccine is recommended for all people living with HIV over the age of 50, with CD4 counts greater than 200 cells/mm3without concern for reactivation from a live virus vaccine.Whether this vaccine should be used for those with CD4 less than 200 cells/µL is still under review.
When to See Your DoctorTo avoid complications, see your doctor immediately if you have HIV and suspect shingles.
When to See Your Doctor
To avoid complications, see your doctor immediately if you have HIV and suspect shingles.
At times, shingles flares up after people with HIV start treatment. This is due to a mechanism called immune reconstitution inflammatory syndrome, or IRIS. IRIS is a state of a hyperinflammatory response, a complication as a result of antiretroviral therapy (ART), and usually happens within the first six months of treatment.
A Word From Verywell
Those with HIV are more prone to developing shingles, as well as experiencing shingles-related complications. This is especially true for those with untreated HIV, in early treatment for HIV, and with stage 3 HIV. However, people without any particular immunocompromising condition can also get shingles. See your doctor immediately if you have HIV and suspect shingles to avoid complications. Quick, effective treatment is vital to controlling the course of shingles.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Brahe C, Ellis R.Got shingles? Test for HIV. Severe shingles as first presenting infection in HIV/AIDS patient.IDCases. 2020;19:e00725. doi:10.1016/j.idcr.2020.e00725Kong CL, Thompson RR, Porco TC, Kim E, Acharya NR.Incidence rate of herpes zoster ophthalmicus: a retrospective cohort study from 1994 through 2018.Ophthalmology. 2020;127(3):324-330. doi:10.1016/j.ophtha.2019.10.001Ubani U.Herpes-zoster virus ophthalmicus as presenting sign of HIV disease.Journal of Optometry. 2011;4(4):117-121. doi:10.1016/S1888-4296(11)70052-8Centers for Disease Control and Prevention.Shingles (herpes zoster): Signs & symptoms.Blank LJ, Polydefkis MJ, Moore RD, Gebo KA.Herpes zoster among persons living with HIV in the current antiretroviral therapy era.JAIDS Journal of Acquired Immune Deficiency Syndromes. 2012;61(2):203-207. doi:10.1097/QAI.0b013e318266cd3cHIV.info.NIH.gov.HIV Treatment.HIV.gov.Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV.Centers for Disease Control and Prevention.What Everyone Should Know about the Shingles Vaccine (Shingrix).
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Brahe C, Ellis R.Got shingles? Test for HIV. Severe shingles as first presenting infection in HIV/AIDS patient.IDCases. 2020;19:e00725. doi:10.1016/j.idcr.2020.e00725Kong CL, Thompson RR, Porco TC, Kim E, Acharya NR.Incidence rate of herpes zoster ophthalmicus: a retrospective cohort study from 1994 through 2018.Ophthalmology. 2020;127(3):324-330. doi:10.1016/j.ophtha.2019.10.001Ubani U.Herpes-zoster virus ophthalmicus as presenting sign of HIV disease.Journal of Optometry. 2011;4(4):117-121. doi:10.1016/S1888-4296(11)70052-8Centers for Disease Control and Prevention.Shingles (herpes zoster): Signs & symptoms.Blank LJ, Polydefkis MJ, Moore RD, Gebo KA.Herpes zoster among persons living with HIV in the current antiretroviral therapy era.JAIDS Journal of Acquired Immune Deficiency Syndromes. 2012;61(2):203-207. doi:10.1097/QAI.0b013e318266cd3cHIV.info.NIH.gov.HIV Treatment.HIV.gov.Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV.Centers for Disease Control and Prevention.What Everyone Should Know about the Shingles Vaccine (Shingrix).
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Brahe C, Ellis R.Got shingles? Test for HIV. Severe shingles as first presenting infection in HIV/AIDS patient.IDCases. 2020;19:e00725. doi:10.1016/j.idcr.2020.e00725Kong CL, Thompson RR, Porco TC, Kim E, Acharya NR.Incidence rate of herpes zoster ophthalmicus: a retrospective cohort study from 1994 through 2018.Ophthalmology. 2020;127(3):324-330. doi:10.1016/j.ophtha.2019.10.001Ubani U.Herpes-zoster virus ophthalmicus as presenting sign of HIV disease.Journal of Optometry. 2011;4(4):117-121. doi:10.1016/S1888-4296(11)70052-8Centers for Disease Control and Prevention.Shingles (herpes zoster): Signs & symptoms.Blank LJ, Polydefkis MJ, Moore RD, Gebo KA.Herpes zoster among persons living with HIV in the current antiretroviral therapy era.JAIDS Journal of Acquired Immune Deficiency Syndromes. 2012;61(2):203-207. doi:10.1097/QAI.0b013e318266cd3cHIV.info.NIH.gov.HIV Treatment.HIV.gov.Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV.Centers for Disease Control and Prevention.What Everyone Should Know about the Shingles Vaccine (Shingrix).
Brahe C, Ellis R.Got shingles? Test for HIV. Severe shingles as first presenting infection in HIV/AIDS patient.IDCases. 2020;19:e00725. doi:10.1016/j.idcr.2020.e00725
Kong CL, Thompson RR, Porco TC, Kim E, Acharya NR.Incidence rate of herpes zoster ophthalmicus: a retrospective cohort study from 1994 through 2018.Ophthalmology. 2020;127(3):324-330. doi:10.1016/j.ophtha.2019.10.001
Ubani U.Herpes-zoster virus ophthalmicus as presenting sign of HIV disease.Journal of Optometry. 2011;4(4):117-121. doi:10.1016/S1888-4296(11)70052-8
Centers for Disease Control and Prevention.Shingles (herpes zoster): Signs & symptoms.
Blank LJ, Polydefkis MJ, Moore RD, Gebo KA.Herpes zoster among persons living with HIV in the current antiretroviral therapy era.JAIDS Journal of Acquired Immune Deficiency Syndromes. 2012;61(2):203-207. doi:10.1097/QAI.0b013e318266cd3c
HIV.info.NIH.gov.HIV Treatment.
HIV.gov.Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV.
Centers for Disease Control and Prevention.What Everyone Should Know about the Shingles Vaccine (Shingrix).
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