Varicella-Zoster Virus Infection
Prevention of Exposure
HIV-infected children and adults who are susceptible to varicella-zoster
virus (VZV) (i.e., those who have no history of chickenpox or shingles or
are seronegative for VZV) should avoid exposure to persons with chickenpox
or shingles. Although vaccination against varicella is currently under
investigation in HIV-infected children, based on current information, vaccine
against varicella should not be administered to adults or children who are
infected with HIV because of the potential for disseminated viral infection. Household contacts (especially children) of susceptible HIV-infected
persons should be vaccinated against VZV if they have no history of chicken-pox
and are seronegative for HIV, so that they will not transmit VZV to their
susceptible HIV-infected contact.
Prevention of Disease
For the prophylaxis of chickenpox, HIV-infected children and adults who
are susceptible to VZV (i.e., those who have no history of chickenpox or
shingles or who have no detectable antibody against VZV) should be administered
varicella zoster immune globulin (VZIG) as soon as possible but within 96
hours after close contact with a patient who has chickenpox or shingles.
Data are lacking on the effectiveness of acyclovir for preventing chickenpox
in susceptible HIV-infected children or adults, although such an approach
would be logical.
No preventive measures are currently available for shingles.
Prevention of Recurrence
No drug has been proven to prevent recurrence of shingles in HIV-infected
persons.
Note:
Note Regarding Pregnancy
VZIG is recommended for VZV-susceptible pregnant women within 96
hours after exposure to VZV. If oral acyclovir is used, VZV serology
should be per-formed so that the drug can be discontinued if the patient
is seropositive for VZV.
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