Changing epidemiological and clinical profile of herpes zoster

Abstract

Herpes zoster is a viral infection characterised by unilateral grouped vesicular eruption caused by varicella zoster virus. It occurs because of reactivation of the latent virus in the sensory root ganglion. This article aims to study the incidence, clinical profile, precipitating factors, type of dermatomal involvement and clinical variations of herpes zoster along with its association with HIV infection. The study was done at VS Hospital, Ahmedabad and total of 120 patients (72 male and 48 females) were included in the study. All patients (of all ages) diagnosed clinically as herpes zoster and confirmed by Tzanck smear were included in the study. Data related to demographic profile, clinical profile and complications of herpes zoster was collected and analysed. All patients were also screened for HIV and other comorbidities. Most patients presented with vesicular lesions and the most common prodrome was burning sensation. Thoracic ganglion was most commonly involved. The most frequent complications were post herpetic neuralgia and dyspigmentation. Nineteen of our patients had multidermatomal involvement. Twenty of 120 patients (16.6%) of herpes zoster were HIV positive. Twelve of 120 patients were below 12 years of age. The chances of post herpetic neuralgia increased when treatment was initiated late. This study helped analyse the varied clinical presentations and complications of herpes zoster. Herpes zoster serves as an important early marker for HIV infection. Interesting change in trend was noticed in the demography of herpes zoster and its relatively high incidence in the paediatric age group.