From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Federal University of Sao Paulo, Sao Paulo, Brazil.
Pediatric Rheumatology Unit, Department of Pediatrics, Federal University of Sao Paulo, Sao Paulo, Brazil.
Pediatr Infect Dis J. 2020 Jul;39(7):624-627. doi: 10.1097/INF.0000000000002617.
HIV infection and juvenile systemic lupus erythematosus (jSLE) are risk factors for the development of herpes zoster (HZ) and its complications. Both diseases share similar immunologic aspects, such as immunodeficiency and immune activation. Therefore, our objective was to evaluate and compare the frequency and characteristics of HZ episodes in pediatric patients with HIV infection and jSLE.
A retrospective cohort study was carried out with the evaluation of 2 pediatric cohorts: HIV patients who were followed from January 1987 to December 2014 and patients with jSLE followed up from January 1990 to December 2014 in outpatient clinics.
Of the 190 HIV patients, 48 had HZ (25.3%), with 67 episodes; of the 92 patients with jSLE, 27 had HZ (29.3%), totaling 28 episodes. The median age at the first episode of HZ was higher in the jSLE than in the HIV group (8.9 vs. 12.5 years, respectively) (P = 0.020). HIV patients were more likely to have recurrent HZ (P = 0.025). In addition, there was a tendency for HIV patients to present with disseminated HZ more frequently (P = 0.060). Although the hospitalization rate was similar between groups, patients with jSLE received intravenous acyclovir more frequently (P = 0.014). When HIV non-immune reconstitution syndrome patients were compared with jSLE group, recurrence of HZ in HIV was the only significant difference between groups (P = 0.017).
Patients with HIV had more recurrent HZ than patients with jSLE.
HIV 感染和青少年系统性红斑狼疮（jSLE）是带状疱疹（HZ）及其并发症发展的危险因素。这两种疾病具有相似的免疫方面，如免疫缺陷和免疫激活。因此，我们的目的是评估和比较感染 HIV 的儿科患者和 jSLE 患者 HZ 发作的频率和特征。
对 1987 年 1 月至 2014 年 12 月期间随访的 HIV 患者和 1990 年 1 月至 2014 年 12 月期间在门诊接受随访的 jSLE 患者进行回顾性队列研究。
在 190 名 HIV 患者中，48 名（25.3%）发生 HZ，共 67 例；92 名 jSLE 患者中，27 名（29.3%）发生 HZ，共 28 例。jSLE 组 HZ 首次发作的中位年龄高于 HIV 组（分别为 8.9 岁和 12.5 岁）（P=0.020）。HIV 患者更易发生复发性 HZ（P=0.025）。此外，HIV 患者更易出现播散性 HZ（P=0.060）。尽管两组的住院率相似，但 jSLE 患者更常接受静脉用阿昔洛韦治疗（P=0.014）。当将 HIV 非免疫重建综合征患者与 jSLE 组进行比较时，HIV 组中 HZ 的复发是两组之间唯一的显著差异（P=0.017）。
与 jSLE 患者相比，HIV 患者的 HZ 复发更多。
