Wallace M R, Hooper D G, Pyne J M, Graves S J, Malone J L
Department of Internal Medicine (Infectious Disease Division), Naval Hospital, San Diego, Calif. 92134-5000.
South Med J. 1994 Jan;87(1):74-6. doi: 10.1097/00007611-199401000-00016.
Varicella is an infrequent but potentially severe infection in adult HIV-infected patients. We reviewed five cases of varicella in HIV-seropositive men; two were complicated by severe headache and meningismus, and one of these patients also had hepatitis and thrombocytopenia. All five patients responded well to acyclovir therapy, but one patient had dermatomal zoster 2 years later, and another failed to have detectable antibody after infection. We also performed a serosurvey on 181 consecutive HIV-infected patients presenting themselves for evaluation. A total of 95% of these patients had demonstrable antibody to varicella-zoster virus. Immune status to varicella did not correlate with the declining CD4 count, which was well preserved even in patients with fewer than 200 CD4 cells/mm3.
水痘在成年HIV感染患者中虽不常见，但可能是严重感染。我们回顾了5例HIV血清阳性男性的水痘病例；2例并发严重头痛和颈项强直，其中1例患者还患有肝炎和血小板减少症。所有5例患者对阿昔洛韦治疗反应良好，但1例患者在2年后发生带状疱疹，另1例患者感染后未能检测到抗体。我们还对181例前来接受评估的连续HIV感染患者进行了血清学调查。这些患者中共有95%对水痘-带状疱疹病毒有可检测到的抗体。水痘免疫状态与CD4细胞计数下降无关，即使在CD4细胞少于200个/mm³的患者中，CD4细胞计数也保存良好。
