Herpes Zoster Ophtalmicus in a HIV positive patient: A Case Report

We present a 27-years-old female patient, who was diagnosed HIV positive in Appelsbosch Hospital, rural South Africa, and subsequently presented with a severe herpes zoster ophtalmicus. The patient had an initial CD4 cell count of 112 cell/mm3 and a Viral Load of 1300000. The patient was initially managed in our facility and eventually referred to the ophthalmologist who diagnosed her as having a severe uveitis or chorioretinitis. BACKGROUND Herpes Zoster is a common infection caused by the human herpes virus 3, the same virus that causes chickenpox. It is a member of herpes viridae, the same family as the herpes simplex virus, Epstein-Barr virus, and cytomegalovirus. Herpes zoster ophthalmicus occurs when a latent varicella zoster virus in the trigeminal ganglia involving the ophthalmic division of the nerve is reactivated. Of the three divisions of the fifth cranial nerve, the ophthalmic is involved 20 times more frequently than the other divisions. HIV positive patients have a 15 �25 times greater prevalence of zoster compared to the general population. 1 HIV is a major health problem in South African communities and although access to antiretroviral treatment has greatly improved, patients still arrive very late to clinics and hospitals Despite all the efforts patients still arrive late to the HIV/AIDS management services and with advanced immune deficiency. Severe forms of opportunistic infections and complications are common.