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ERROR: type should be string, got "https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly93d3cubWVkc2NhcGUuY29tL2Fuc3dlcnMvMjExODczLTE3MDYzOS8xOTk1MTE0LW92ZXJ2aWV3\nDrugs & Diseases > Infectious Diseases > Early Symptomatic HIV Infection Q&A\nWhat is the prevalence of shingles in patients with HIV infection?\nAuthor: Robert J Carpenter, DO, FACP; Chief Editor: John Bartlett, MD more...\nReactivation of varicella-zoster virus (shingles) occurs in 10-20% of patients infected with HIV. Onset of shingles indicates a modest decline in immune function and is often the first clinical indication of immunodeficiency.\nPilcher CD, Eron JJ Jr, Galvin S, Gay C, Cohen MS. Acute HIV revisited: new opportunities for treatment and prevention. J Clin Invest. 2004 Apr. 113(7):937-45. [Medline].\nZetola NM, Pilcher CD. Diagnosis and management of acute HIV infection. Infect Dis Clin North Am. 2007 Mar. 21(1):19-48, vii. [Medline].\nBettaieb A, Fromont P, Louache F, et al. Presence of cross-reactive antibody between human immunodeficiency virus (HIV) and platelet glycoproteins in HIV-related immune thrombocytopenic purpura. Blood. 1992 Jul 1. 80(1):162-9. [Medline].\nTruong HM, Grant RM, McFarland W, Kellogg T, Kent C, Louie B. Routine surveillance for the detection of acute and recent HIV infections and transmission of antiretroviral resistance. AIDS. 2006 Nov 14. 20(17):2193-7. [Medline].\nPilcher CD, Fiscus SA, Nguyen TQ, Foust E, Wolf L, Williams D. Detection of acute infections during HIV testing in North Carolina. N Engl J Med. 2005 May 5. 352(18):1873-83. [Medline].\nMylonakis E, Paliou M, Lally M, et al. Laboratory testing for infection with the human immunodeficiency virus: established and novel approaches. Am J Med. 2000 Nov. 109(7):568-76. [Medline].\n[Guideline] Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. January 10, 2011; 1-174. Available at http://aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL.pdf. Accessed: June 16, 2011.\nStreeck H, Jessen H, Alter G, Teigen N, Waring MT, Jessen A. Immunological and virological impact of highly active antiretroviral therapy initiated during acute HIV-1 infection. J Infect Dis. 2006 Sep 15. 194(6):734-9. [Medline].\nHecht FM, Wang L, Collier A, Little S, Markowitz M, Margolick J. A multicenter observational study of the potential benefits of initiating combination antiretroviral therapy during acute HIV infection. J Infect Dis. 2006 Sep 15. 194(6):725-33. [Medline].\nFidler S, Fox J, Touloumi G, Pantazis N, Porter K, Babiker A. Slower CD4 cell decline following cessation of a 3 month course of HAART in primary HIV infection: findings from an observational cohort. AIDS. 2007 Jun 19. 21(10):1283-91. [Medline].\nStrategies for Management of Antiretroviral Therapy (SMART) Study Group, Emery S, Neuhaus JA, Phillips AN, Babiker A, Cohen CJ, et al. Major clinical outcomes in antiretroviral therapy (ART)-naive participants and in those not receiving ART at baseline in the SMART study. J Infect Dis. 2008 Apr 15. 197(8):1133-44. [Medline].\nUS Department of Health and Human Services. National Institutes of Health. NIH News. Starting Antiretroviral Therapy Earlier Yields Better Clinical Outcomes. June 8, 2009. Available at http://www.nih.gov/news/health/jun2009/niaid-08a.htm.\nGrant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L, et al. Preexposure Chemoprophylaxis for HIV Prevention in Men Who Have Sex with Men. N Engl J Med. 2010 Nov 23. [Medline].\nCohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011 Aug 11. 365(6):493-505. [Medline]. [Full Text].\nChoopanya K, Martin M, Suntharasam P, Sangkum U, Mock P, Leethochawalit M, et al. Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomized, double-blind, placebo-controlled phase 3 trial. Lancet. 2013. 2083-90.\nCenters for Disease Control and Prevention (CDC). Update to interim guidance for preexposure prophylaxis (PrEP) for the prevention of HIV injection: PrEP for injecting drug users. Available at http://www.cdc.gov/nchhstp/newsroom/2013/PrEP-Interim-Guidance.html. Accessed: June 13, 2013.\nAberg JA, Kaplan JE, Libman H, Emmanuel P, Anderson JR, Stone VE, et al. Primary care guidelines for the management of persons infected with human immunodeficiency virus: 2009 update by the HIV medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2009 Sep 1. 49(5):651-81. [Medline].\nCDC. Pre-Exposure Prophylaxis (PrEP) for HIV Prevention: Promoting Safe and Effective Use in the United States. CDC. Available at http://www.cdc.gov/nchhstp/Newsroom/PrEPforHIVFactSheet.html. Accessed: 11/29/2010.\niPrEx Study Results: Public Statement. Gilead. Available at http://www.gilead.com/iPrEx_statement. Accessed: 11/29/2010.\nElectron microscopy of human immunodeficiency virus (HIV)–1 virions. Courtesy of CDC/Dr. Edwin P. Ewing, Jr.\nRobert J Carpenter, DO, FACP CTF-80 Surgeon, US Fleet Forces Command\nRobert J Carpenter, DO, FACP is a member of the following medical societies: American College of Physicians, American Osteopathic Association, Infectious Diseases Society of America\nJohn Bartlett, MD Professor Emeritus, Johns Hopkins University School of Medicine\nJohn Bartlett, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Clinical Pharmacology, American College of Physicians, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, American Thoracic Society, American Venereal Disease Association, Association of American Physicians, Infectious Diseases Society of America, Society of Critical Care Medicine\nKirk M Chan-Tack, MD Medical Officer, Division of Antiviral Products, Center for Drug Evaluation and Research, Food and Drug Administration\nJoseph F John, Jr, MD, FACP, FIDSA, FSHEA Clinical Professor of Medicine, Molecular Genetics and Microbiology, Medical University of South Carolina College of Medicine; Associate Chief of Staff for Education, Ralph H Johnson Veterans Affairs Medical Center\nJoseph F John, Jr, MD, FACP, FIDSA, FSHEA is a member of the following medical societies: Charleston County Medical Association, Infectious Diseases Society of America, South Carolina Infectious Diseases Society\nFred A Lopez, MD Associate Professor and Vice Chair, Department of Medicine, Assistant Dean for Student Affairs, Louisiana State University School of Medicine\nFred A Lopez, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, Infectious Diseases Society of America, Louisiana State Medical Society\nThe authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author Braden R Hale, MD, MPH, to the development and writing of the source article."