Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Oct;104(4):455-60. Epub 2007 Jun 29.

Herpes zoster infection as an immune reconstitution inflammatory syndrome in HIV-seropositive subjects: a review.

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Department of Periodontology and Oral Medicine, School of Dentistry, Faculty of Health Sciences, University of Limpopo, Medunsa Campus, South Africa. lfeller@medunsa.ac.za

Abstract

The use of highly active antiretroviral therapy (HAART) in the management of human immunodeficiency virus (HIV) infection has resulted paradoxically in the worsening of clinical symptoms of previously subclinical infections, such as herpes zoster (HZ), herpes simplex, angular cheilitis, warts, tuberculosis, hepatitis B and C, cytomegalovirus retinitis, and others, as a result of substantial reconstitution of the host's immune responses. This phenomenon is referred to as immune reconstitution inflammatory syndrome (IRIS). It may affect up to 32% of HIV-seropositive subjects within a wide range of time after the initiation of HAART, but mainly after 8-12 weeks. Mucocutaneous HZ accounts for 7%-12% of the diseases associated with HIV infection that become worse again when the subject's immunity improves from the administration of HAART. It usually occurs after 4 weeks from the initiation of HAART, and under these circumstances the clinical symptoms and natural course of mucocutaneous HZ are similar to those in HIV-seropositive subjects who do not manifest IRIS.

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