Disseminated herpes zoster and some other infections may navigated to newly-diagnosed human immunodeficiency virus infection

Ni Putu Nita Wiryandari; Ketut Suryana

doi:10.18203/2320-6012.ijrms20222283

Authors

Ni Putu Nita Wiryandari Department of Internal Medicine, Merpati Clinic, HIV and Allergy - Clinical Immunology Services Unit, Wangaya Hospital in Denpasar, Bali, Indonesia http://orcid.org/0000-0001-5411-1249
Ketut Suryana Department of Internal Medicine, Merpati Clinic, HIV and Allergy - Clinical Immunology Services Unit, Wangaya Hospital in Denpasar, Bali, Indonesia

DOI:

https://doi.org/10.18203/2320-6012.ijrms20222283

Keywords:

Disseminated herpes zoster, Oropharyngeal and esophageal candidiasis, Pneumocystis pneumonia, Pulmonary tuberculosis, Newly diagnosed HIV infection

Abstract

Almost half of the human immunodeficiency virus (HIV)-positive patients are late diagnosed, which is always associated with higher mortality and morbidity due to various opportunistic infections (OI). Thus, recognition of HIV indicator conditions is important for HIV screening. Cluster of differentiation 4 (CD4) counts <200 cells/mm³ are at the highest risk of herpes zoster-related complications, including disseminated herpes zoster (HZ). Oral candidiasis (OC) is a clinical predictor of HIV infection progression. Here we report a 52-year-old female presented with grouped vesicles with bulla on dermatome L2-L4 sinistra and multiple scattering erythematous vesicular rashes on the whole body. White patches on the tongue with painful swallowing and progressive shortness of breath, cough, low-grade fever, and night sweats. She had an unintentional weight loss of 15 kg. Chest radiograph showed infiltrates in the left lung and right para hilar and paracardial fields, negative Xpert MTB/RIF, and patient newly diagnosed with advanced HIV infection (reactive result on provider initiative test and counseling (PITC) with CD4 level was 8 cell/ml). The patient showed improvement after early treatment with antiviral, antifungal, antimicrobial, first-line fixed-dose combination (FDC) tuberculosis, and prophylactic antibiotic.

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References

UNAIDS. Global HIV & AIDS statistics, 2022. Available at: http://www.unaid s.org/en/resou rces/fact-sheet. Accessed on 11 July 2022.

Hu X, Liang B, Zhou C, Jiang J, Huang J, Ning C. HIV late presentation and advanced HIV disease among patients with newly diagnosed HIV/AIDS in Southwestern China: a large‑scale cross‑sectional study. AIDS Res Ther. 2019;16:6.

Xie J, Hsieh E, Sun MQ, Wang HL, Lv W, Fan HW, Li TS. Delays in HIV diagnosis and associated factors among patients presenting with advanced disease at a tertiary care hospital in Beijing, China. PLoS One. 2017;12(8):e0182335.

Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV; Varicella-Zoster Virus Diseases. 2019.

Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;62(4):1-50.

Suryana K, Suharsono H, Antara PJ. Factor Associated with Oral Candidiasis in People Living with HIV/AIDS: A Case Control Study. HIV AIDS (Auckl). 2020;12:33-9.

World Health Organization. Guidelines For Managing Advanced HIV Disease and Rapid Initiation of Antiretroviral Therapy. 2017. Available at: https://www.who.int/publications/i/item/9789241550062. Accessed on 11 July 2022.

Raben D, Sullivan AK, Mocroft A, Kutsyna G, Hadzˇiosmanović V, Vassilenko A, et al. Improving the evidence for indicator condition guided HIV testing in Europe: Results from the HIDES II Study – 2012–2015. PLoS One. 2019;14(8):e0220108.

Raben D, Mocroft A, Rayment M, Mitsura VM, Hadziosmanovic V, Sthoeger ZM, et al. Auditing HIV Testing Rates across Europe: Results from the HIDES 2 Study. PLoS One. 2015;10(11):e0140845.

Shin BS, Na CH, Song IG, Choi KC. A Case of Human Immunodeficiency Virus Infection Initially Presented with Disseminated Herpes Zoster. Ann Dermatol. 2010;22(2):199-202.

Leung AKC, Barankin B. Herpes Zoster in Childhood. Open J Pediatrics. 2015;5(1):39-44.

Patil, A.; Goldust, M.; Wollina, U. Herpes zoster: A Review of Clinical Manifestations and Management. Viruses. 2022;14(2):192.

Skalski JH, Limper AH. Fungal, Viral, and Parasitic Pneumonias Associated with Human Immunodeficiency Virus. Semin Respir Crit Care Med. 2016;37(2):257-66.

Dufaur L, Matin N. Important opportunistic infections in HIV. HIV Complication. 2018;46(6):352-5.

World Health Organization. WHO operational handbook on tuberculosis Module 2: Systemetic screening for tuberculosis disease. 2021. Available at: https://www.who.int/publications/i/item/9789240022614. Accessed on 11 July 2022.

Lewinsohn DM, Leonard MK, LoBue, PA, Cohn, DL, Daley CL, Desmond E. Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention Clinical Practice Guidelines: Diagnosis of Tuberculosis in Adults and Children. Clin Infect Dis. 2017;64(2):111-5.