HIV: Zoster Risk May Rise Slightly In First 6 months of Treatment, Declines Overall Interview with:
Dr Sophie Grabar, MD, PhD
Unité de Biostatistique et Epidémiologie (Aile B2-5ieme étage)
Groupe Hospitalier Cochin Broca Hôtel-Dieu PARIS

Medical Research: What is the background for this study?

Dr. Grabar: We took advantage of a large cohort, the French Hospital on HIV-ANRS CO4 cohort, of more than 100 000 HIV-infected patients to study the incidence trends and risk factors of Herpes Zoster since the advent of cART (combination antiretroviral medications)that have been discrepantly reported in the literature. Also, because Herpes Zoster has been associated with Immune Reconstitution Inflammatory Syndrome, we studied the early impact of cART initiation on the risk of Herpes Zoster and finally evaluated the risk with regards to the risk in the general population that has never been reevaluated in recent years.

Medical Research: What are the main findings?

Dr. Grabar: We found that the incidence of Herpes Zoster has significantly declined with the arrival of cART and continue to decline probably owing to the immune recovery induced by cART. The risk in HIV-infected patients is globally 3-times higher to that of the general population, and 6-times higher between 15-45 years. Among cART naive patients, we found that the risk of Herpes Zoster increases in the first months of cART initiation but only moderately while it sharply decreases after 6 months of cART.

Medical Research: What should clinicians and patients take away from your report?

Dr. Grabar: Clinicians and patients should be aware that cART transiently increases the risk of Herpes Zoster during the first 6 months of treatment.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. GrabarAlthough reassuring our study confirms the persisting over-risk of Herpes Zoster in HIV-infected patients that may call for an evaluation of Herpes Zoster vaccines in HIV-infected patients below the age of 60.


Incidence of Herpes Zoster in HIV-Infected Adults in the Combined Antiretroviral Therapy Era: Results From the FHDH-ANRS CO4 Cohort

Grabar S1, Tattevin P2, Selinger-Leneman H3, de La Blanchardiere A4, de Truchis P5, Rabaud C6, Rey D7, Daneluzzi V8, Ferret S9, Lascaux AS10, Hanslik T11, Costagliola D3, Launay O12; for the French Hospital Database on HIV (FHDH-ANRS CO4 Cohort).

Clin Infect Dis. 2015 Jan 18. pii: ciu1161. [Epub ahead of print]

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