Soropositividade para HIV em doentes de herpes zoster

Vasconcellos, Mônica R. A.; Castro, Luiz G. M.; Santos, Maurici F. dos

doi:10.1590/S0036-46651990000500010

Resumos

Os autores estudam a relação de zoster com soropositividade para HIV. Foram testados soros de 66 pacientes (31 homens e 35 mulheres) com quadro agudo de zoster, usando-se o método de ELISA para detectar anticorpos anti-HIV. Não houve seleção dos pacientes, evitando assim lidar com amostra viciada. Entre os 7 HIV +, 6 pertenciam a grupo de risco para AIDS, todos eram do sexo masculino e seis tinham idade entre 19 e 39 anos (idade média de 31,7 anos). Os resultados sugerem que o diagnóstico de herpes zoster em pacientes jovens não se vincule necessariamente à infecção pelo HIV. Quando, no entanto, o doente pertence a grupo de risco para AIDS, independentemente de sua idade, existe associação estatisticamente significativa, tornando-se imperativa a pesquisa de anticorpos anti-HIV.

Herpes Zoster; HIV

Relationship between zoster and seropositivity for HIV is studied. Serum samples from 66 patients presenting acute zoster infection were tested for HIV antibodies, using ELISA. There was no previous selection of patients, what rendered the population studied unbiased. Seven patients (10.6%) were positive for HIV antibodies. Among them six belonged to AIDS risk groups, all were males and six had ages between 19 and 39 years (mean age value 31.7). Results suggest that the finding of zoster in younger age groups is not necessarily linked to HIV infection. When zoster is diagnosed in patients who belong to AIDS risk groups, independently from their age, the association with HIV infection is statistically significative. In these cases zoster can even be considered as a marker for HIV infection and it is mandatory to test these patients for HIV antibodies.

SOROLOGIA

Soropositividade para HIV em doentes de herpes zoster⁽¹ (1 ) Trabalho realizado na Disciplina de Dermatologia da Escola Paulista de Medicina e no Departamento de Dermatologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. ⁾

Seropositivity for HIV among zoster patients

Mônica R. A. Vasconcellos^I; Luiz G. M. Castro^I,II; Maurici F. dos Santos^II

^IDisciplina de Dermatologia da Escola Paulista de Medicina. São Paulo, SP, Brasil

^IIDepartamento de Dermatologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. São Paulo, SP, Brasil

^{Endereço para correspondência} Endereço para correspondência: Dr. Luiz G. M. Castro Clínica de Moléstias da Pele Rua Capital Federal, 95 CEP 01259 São Paulo, SP, Brasil

RESUMO

Os autores estudam a relação de zoster com soropositividade para HIV. Foram testados soros de 66 pacientes (31 homens e 35 mulheres) com quadro agudo de zoster, usando-se o método de ELISA para detectar anticorpos anti-HIV. Não houve seleção dos pacientes, evitando assim lidar com amostra viciada. Entre os 7 HIV +, 6 pertenciam a grupo de risco para AIDS, todos eram do sexo masculino e seis tinham idade entre 19 e 39 anos (idade média de 31,7 anos). Os resultados sugerem que o diagnóstico de herpes zoster em pacientes jovens não se vincule necessariamente à infecção pelo HIV. Quando, no entanto, o doente pertence a grupo de risco para AIDS, independentemente de sua idade, existe associação estatisticamente significativa, tornando-se imperativa a pesquisa de anticorpos anti-HIV.

Unitermos: Herpes Zoster; HIV.

SUMMARY

Relationship between zoster and seropositivity for HIV is studied. Serum samples from 66 patients presenting acute zoster infection were tested for HIV antibodies, using ELISA. There was no previous selection of patients, what rendered the population studied unbiased. Seven patients (10.6%) were positive for HIV antibodies. Among them six belonged to AIDS risk groups, all were males and six had ages between 19 and 39 years (mean age value 31.7). Results suggest that the finding of zoster in younger age groups is not necessarily linked to HIV infection. When zoster is diagnosed in patients who belong to AIDS risk groups, independently from their age, the association with HIV infection is statistically significative. In these cases zoster can even be considered as a marker for HIV infection and it is mandatory to test these patients for HIV antibodies.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

AGRADECIMENTOS

Os autores agradecem aos Drs. S. Yamada, O. Rotta e P. Dorlhiac e aos funcionários da Fundação Hemocentro (V. Tanaka, M. N. Y. Novaes, D. F. Chamone e A. R. L. Ruiz) pelo auxílio recebido no desenvolvimento do trabalho e à Profª. Dra. Sabina Gotlieb pelo estudo estatístico.

Recebido para publicação em 02/01/1990.

1. ACHESON, D.W.R.; LEEN, C.L.S.; TARIQ, W.U.Z. & MANDAL, B.K. Severe and recurrent varicella-zoster virus infection in a patient with the acquired immune deficiency syndrome. J. Infect., 16: 193-197, 1988.
2. ALESSI, E.; CUSINI, M.; ZERBONI, R.; CAVICCHINI, S.; UBERTI-FOPPA, C.; GALLI, M. & MORARI, M. Unusual varicella-zoster virus infection in patients with the acquired immune deficiency syndrome. Arch. Derm., 124: 1011-1013, 1988.
3. BALFOUR, H.H. Varicella-zoster virus infections in immunocompromissed hosts. Amer. J. Med., 85 (supl. 2A): 168-173, 1988.
4. BERGES, R.; FLORENT, G. & JUST, M. Decrease of the lymphoproliferative response to varicella-zoster in the aged. Infect. Immun., 32: 24-27, 1981.
5. BERQUÓ, E.S.; PACHECO DE SOUZA, J.M. & GOTLIEB, S.L.D. Bioestatística. Săo Paulo, E. P. U., 1981.
6. BURKE, B.L.; STEELE, R.W.; BEARD, O.W.; WOOD, J.S.; CAIN, T.D. & MARMER, D.J. Immune response to varicella-zoster in the aged. Arch. intern. Med., 142: 291-293, 1982.
7. CASTRO, L.G.M. & CHEN, S. Aspectos epidemiológicos do herpes zoster no PS-derma do HC-FMUSP. In: CONGRESSO BRASILEIRO DE DERMATOLOGIA, 43., Rio de Janeiro, 1988. Resumos. Res. nş 30.
8. CASTRO, L.G.M. & CHEN, S. O herpes zoster é mais freqüente entre jovens que entre idosos. In: WORLD CONGRESS OF DERMATOLOGY, TROPICAL, GEOGRAPHIC AND ECOLOGIC, 6., Rio de Janeiro, 1989. Abstracts. Abst. No. 135.
9. COHEN, P.R.; BELTRANI, V.P. & GROSSMAN, M.E. Disseminated herpes zoster in patients with human immunodeficiency virus infection. Amer. J. Med., 84: 1076-1080, 1988.
10. COLEBUNDERS, R.; MANN, J.M.; FRANCIS, H.; BILA, K.; IZALEY, L.; ILWAYA, M.; KAKONDE, N.; QUINN, T.; CURRAN, J.W. & PIOT, P. Herpes zoster in African patients: a clinical predictor of human immunodeficiency virus infection. J. infect. Dis., 157: 314-318, 1988.
11. COOPER, M. The epidemiology of herpes zoster. Eye, 1: 413-421, 1987.
12. FRIEDMAN-KIEN, A.E.; LAFLEUR, F.L.; GENDLER, E.; HENNISSEY, N.P.; MONTAGNA, R.; HALBERT, S.; RUBINSTEIN, P.; KRASINSKY, K.; ZANG, E. & POIESZ, B. Herpes zoster: an early clinical sign for development of AIDS. J. Amer. Acad. Derm., 14: 1023-1028, 1986.
13. FRIEDMAN-KIEN, A.E. Cutaneous manifestations of AIDS. In: WORLD CONGRESS OF DERMATOLOGY, 18., Berlin, 1987. Proceedings. p. 327-330.
14. HOPE-SIMPSON, R.E. The nature of herpes zoster: a long term study and a new hypothesis. Proc. roy. Soc. Med., 58: 9-20, 1965.
15. KESTELYN, P.; STEVENS, A.M.; BAKKERS, E.; ROUVROY, D. & VAN DE PERRE, P. Severe herpes zoster ophtalmicus in young African adults: a marker for HTLV-III seropositivity. Brit. J. Ophthal., 71: 806-809, 1987.
16. LESBORDES, J.L.; COULAUD, X. & GEORGES, A.J. Le zona élément prédictif ŕ virus de I'immunodéficience humaine type 1 ŕ Bangui (Centrafrique). Press méd., 17: 963, 1988.
17. MAYER DA SILVA, A.; IMCKE, E.; BRATZKE, B. & ORFANOS, C.E. Cutaneous manifestations of acquired immunodeficiencies. In: WORLD CONGRESS OF DERMATOLOGY, 18., Berlin, 1987. Proceedings. p. 334-336.
18. MELBYE, M.; GOEDERT, J.J.; GROSSMAN, R.J.; EYSTER, M.E. & BIGGAR, R.J. Risk of AIDS after herpes zoster. Lancet, 1: 728, 1987.
19. MILLER, A.E. Selective decline in cellular immune response to varicella-zoster in the elderly. Neurology, 30: 582-587, 1980.
20. NDUMBE, P.M.; MACQUEEN, S.; HOLZEL, H. & LEVINSKY, R.J. Immunity to varicella-zoster virus in a normal adult population. J. med. Microbiol., 20: 105-111, 1985.
21. OLIVEIRA FILHO, J.; NUNES, E.A.; CALDO, E.R.; BOSSA, F.V.; ALMEIDA, M.C.M. & GUIDONE, V.G.R. Incidęncia das dermatoviroses no Centro de Saúde Escola da Faculdade de Medicina de Santo Amaro-SP. An. bras. Derm., 63: 353-357, 1988.
22. OXMAN, M.N. Varicella and herpes zoster. In: FITZPATRICK, T.B.; EISEN, A.Z. & WOLFF, K. Dermatology in general medicine. 3rd ed. New York, McGraw-Hill, 1987. p. 2314-2340.
23. PETZOLDT, D. HIV infection: practical questions on the duty to notify and professional security. In: WORLD CONGRESS OF DERMATOLOGY, 18., Berlin, 1987. Proceedings. p. 70-72.
24. ROOK, A. Virus and related infections. In: ROOK, A.; WILKINSON, D.S. & EBLING, F.J.G. Textbook of dermatology. Oxford, Blackwell, 1968. p. 763-767.
25. RUTOWITSCH, M. & RUTOWITSCH, M.S. Zoster. An. bras. Derm., 56: 263-268, 1981.
26. SAMPAIO, S.A.P.; CASTRO, R.M. & RIVITTI, E.A. Dermatologia básica. 3. ed. Săo Paulo, Artes Médicas, 1984.
27. SORENSEN, O.S.; HAAHR, S.; MOLLER-LARSEN, A. & WILDENHOFF, K. Cell-mediated and humoral immunity to herpes viruses during and after herpes zoster infections. Infect. Immun., 29: 369-375, 1980.
28. VAN DE PERRE, P.; BAKKERS, E.; BATUNGWANAYO, J.; KESTELYN, P.; LEPAGE, P.; NZARAMBA, D.; BOGAERTS, J.; SERUFILIRA, A.; ROUVROY, D.; UWIMWNW, A. & BUTZLER, J.P. Herpes zoster in African patients: an early manifestation of HIV infection. Scand. J. infect. Dis., 20: 277-282, 1988.
29. WILKERSON, M.G.; JORDAN, W.B. & KERKERING, T.M. Herpes zoster as a sign of AIDS-related complex. Amer. Fam. Phycn., 36(4): 233-235, 1987.

Endereço para correspondência:

Dr. Luiz G. M. Castro

Clínica de Moléstias da Pele

Rua Capital Federal, 95

CEP 01259 São Paulo, SP, Brasil

(1

) Trabalho realizado na Disciplina de Dermatologia da Escola Paulista de Medicina e no Departamento de Dermatologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo.

Datas de Publicação

Publicação nesta coleção
12 Set 2006
Data do Fascículo
Out 1990

Histórico

Recebido
02 Jan 1990

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ACHESON, D.W.R.; LEEN, C.L.S.; TARIQ, W.U.Z. & MANDAL, B.K. Severe and recurrent varicella-zoster virus infection in a patient with the acquired immune deficiency syndrome. J. Infect., 16: 193-197, 1988.

[2] 2. ALESSI, E.; CUSINI, M.; ZERBONI, R.; CAVICCHINI, S.; UBERTI-FOPPA, C.; GALLI, M. & MORARI, M. Unusual varicella-zoster virus infection in patients with the acquired immune deficiency syndrome. Arch. Derm., 124: 1011-1013, 1988.

[3] 3. BALFOUR, H.H. Varicella-zoster virus infections in immunocompromissed hosts. Amer. J. Med., 85 (supl. 2A): 168-173, 1988.

[4] 4. BERGES, R.; FLORENT, G. & JUST, M. Decrease of the lymphoproliferative response to varicella-zoster in the aged. Infect. Immun., 32: 24-27, 1981.

[5] 5. BERQUÓ, E.S.; PACHECO DE SOUZA, J.M. & GOTLIEB, S.L.D. Bioestatística. Săo Paulo, E. P. U., 1981.

[6] 6. BURKE, B.L.; STEELE, R.W.; BEARD, O.W.; WOOD, J.S.; CAIN, T.D. & MARMER, D.J. Immune response to varicella-zoster in the aged. Arch. intern. Med., 142: 291-293, 1982.

[7] 7. CASTRO, L.G.M. & CHEN, S. Aspectos epidemiológicos do herpes zoster no PS-derma do HC-FMUSP. In: CONGRESSO BRASILEIRO DE DERMATOLOGIA, 43., Rio de Janeiro, 1988. Resumos. Res. nş 30.

[8] 8. CASTRO, L.G.M. & CHEN, S. O herpes zoster é mais freqüente entre jovens que entre idosos. In: WORLD CONGRESS OF DERMATOLOGY, TROPICAL, GEOGRAPHIC AND ECOLOGIC, 6., Rio de Janeiro, 1989. Abstracts. Abst. No. 135.

[9] 9. COHEN, P.R.; BELTRANI, V.P. & GROSSMAN, M.E. Disseminated herpes zoster in patients with human immunodeficiency virus infection. Amer. J. Med., 84: 1076-1080, 1988.

[10] 10. COLEBUNDERS, R.; MANN, J.M.; FRANCIS, H.; BILA, K.; IZALEY, L.; ILWAYA, M.; KAKONDE, N.; QUINN, T.; CURRAN, J.W. & PIOT, P. Herpes zoster in African patients: a clinical predictor of human immunodeficiency virus infection. J. infect. Dis., 157: 314-318, 1988.

[11] 11. COOPER, M. The epidemiology of herpes zoster. Eye, 1: 413-421, 1987.

[12] 12. FRIEDMAN-KIEN, A.E.; LAFLEUR, F.L.; GENDLER, E.; HENNISSEY, N.P.; MONTAGNA, R.; HALBERT, S.; RUBINSTEIN, P.; KRASINSKY, K.; ZANG, E. & POIESZ, B. Herpes zoster: an early clinical sign for development of AIDS. J. Amer. Acad. Derm., 14: 1023-1028, 1986.

[13] 13. FRIEDMAN-KIEN, A.E. Cutaneous manifestations of AIDS. In: WORLD CONGRESS OF DERMATOLOGY, 18., Berlin, 1987. Proceedings. p. 327-330.

[14] 14. HOPE-SIMPSON, R.E. The nature of herpes zoster: a long term study and a new hypothesis. Proc. roy. Soc. Med., 58: 9-20, 1965.

[15] 15. KESTELYN, P.; STEVENS, A.M.; BAKKERS, E.; ROUVROY, D. & VAN DE PERRE, P. Severe herpes zoster ophtalmicus in young African adults: a marker for HTLV-III seropositivity. Brit. J. Ophthal., 71: 806-809, 1987.

[16] 16. LESBORDES, J.L.; COULAUD, X. & GEORGES, A.J. Le zona élément prédictif ŕ virus de I'immunodéficience humaine type 1 ŕ Bangui (Centrafrique). Press méd., 17: 963, 1988.

[17] 17. MAYER DA SILVA, A.; IMCKE, E.; BRATZKE, B. & ORFANOS, C.E. Cutaneous manifestations of acquired immunodeficiencies. In: WORLD CONGRESS OF DERMATOLOGY, 18., Berlin, 1987. Proceedings. p. 334-336.

[18] 18. MELBYE, M.; GOEDERT, J.J.; GROSSMAN, R.J.; EYSTER, M.E. & BIGGAR, R.J. Risk of AIDS after herpes zoster. Lancet, 1: 728, 1987.

[19] 19. MILLER, A.E. Selective decline in cellular immune response to varicella-zoster in the elderly. Neurology, 30: 582-587, 1980.

[20] 20. NDUMBE, P.M.; MACQUEEN, S.; HOLZEL, H. & LEVINSKY, R.J. Immunity to varicella-zoster virus in a normal adult population. J. med. Microbiol., 20: 105-111, 1985.

[21] 21. OLIVEIRA FILHO, J.; NUNES, E.A.; CALDO, E.R.; BOSSA, F.V.; ALMEIDA, M.C.M. & GUIDONE, V.G.R. Incidęncia das dermatoviroses no Centro de Saúde Escola da Faculdade de Medicina de Santo Amaro-SP. An. bras. Derm., 63: 353-357, 1988.

[22] 22. OXMAN, M.N. Varicella and herpes zoster. In: FITZPATRICK, T.B.; EISEN, A.Z. & WOLFF, K. Dermatology in general medicine. 3rd ed. New York, McGraw-Hill, 1987. p. 2314-2340.

[23] 23. PETZOLDT, D. HIV infection: practical questions on the duty to notify and professional security. In: WORLD CONGRESS OF DERMATOLOGY, 18., Berlin, 1987. Proceedings. p. 70-72.

[24] 24. ROOK, A. Virus and related infections. In: ROOK, A.; WILKINSON, D.S. & EBLING, F.J.G. Textbook of dermatology. Oxford, Blackwell, 1968. p. 763-767.

[25] 25. RUTOWITSCH, M. & RUTOWITSCH, M.S. Zoster. An. bras. Derm., 56: 263-268, 1981.

[26] 26. SAMPAIO, S.A.P.; CASTRO, R.M. & RIVITTI, E.A. Dermatologia básica. 3. ed. Săo Paulo, Artes Médicas, 1984.

[27] 27. SORENSEN, O.S.; HAAHR, S.; MOLLER-LARSEN, A. & WILDENHOFF, K. Cell-mediated and humoral immunity to herpes viruses during and after herpes zoster infections. Infect. Immun., 29: 369-375, 1980.

[28] 28. VAN DE PERRE, P.; BAKKERS, E.; BATUNGWANAYO, J.; KESTELYN, P.; LEPAGE, P.; NZARAMBA, D.; BOGAERTS, J.; SERUFILIRA, A.; ROUVROY, D.; UWIMWNW, A. & BUTZLER, J.P. Herpes zoster in African patients: an early manifestation of HIV infection. Scand. J. infect. Dis., 20: 277-282, 1988.

[29] 29. WILKERSON, M.G.; JORDAN, W.B. & KERKERING, T.M. Herpes zoster as a sign of AIDS-related complex. Amer. Fam. Phycn., 36(4): 233-235, 1987.