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Shingles and HIV: What is the link?

In this article, we look at the link between shingles and HIV, possible complications, and treatments.

How are shingles and HIV related?

People with HIV are more likely to experience shingles, and shingles-related complications, than the general population.

Shingles causes a painful, itchy rash. It develops from the herpes varicella-zoster virus, which is the same virus that causes chickenpox. This virus can lay dormant in the body for years without symptoms.

Anyone who has had chickenpox could develop shingles, which includes around 98 percent of adults in the United States.

The immune system usually suppresses the varicella-zoster virus and prevents outbreaks. However, if a person has a compromised immune system, they may experience shingles symptoms.

A person with HIV may have reduced immune system function if they:

  • have not received treatment
  • are in the earlier stages of treatment
  • have stage 3 HIV

HIV specifically targets and destroys CD4 immune system cells. Having fewer CD4 cells and more HIV in the blood can make a person more susceptible to developing shingles.

Research suggests that people with detectable levels of HIV, measured by a high viral load and low CD4 levels, are more likely to experience shingles.

People may develop shingles shortly after starting to take antiretroviral medications. This indicates that the immune system is getting stronger and starting to respond to specific viruses and bacteria in the body.

The medical community sometimes refers to this as immune reconstitution inflammatory syndrome (IRIS). Around 20 percent of people may experience IRIS after starting antiretroviral therapy.

The best way to boost the immune system is to receive effective treatment for HIV. There are over 30 HIV medicines available in the U.S. Antiretroviral medication can reduce the viral load of HIV in the blood to undetectable levels, allowing the immune system to recover and CD4 counts to rise.

With treatment, a person with HIV can have the same quality of life as a person without HIV, including a reduced risk of catching viral and bacterial infections, such as shingles.

Shingles is a condition that occurs in people who have had chickenpox. The varicella-zoster virus causes chickenpox, and this infection can eventually lead to shingles, usually in adulthood.

Chickenpox is contagious, but shingles is not. To develop shingles, a person would need to have had chickenpox, and this typically happens in early childhood.

If the varicella-zoster virus develops into active shingles, a person will first experience:

  • numbness
  • itching
  • nerve pain, which may be severe
  • tingling

The symptoms of shingles generally occur in a belt-like pattern on the back, chest, or around the eyes and nose. The pattern typically appears on one side of the body.

After the first symptoms, a rash of blisters develops. The blisters eventually burst, forming crusty scabs on the skin. Scratching the blisters can lead to skin infections and scars.

The blisters and rash typically clear within 1–2 weeks. However, the pain could last for months or years after the rash clears.

Most people who have had chickenpox go their entire lives without developing shingles. However, almost 1 in 3 people in the U.S. develop shingles at some point, usually when they are older than 50. The likelihood is higher in people with reduced immune system function.

For shingles, there are many treatment types and options. These therapies can suppress the condition and help manage the symptoms.

Some common treatments for shingles include:

  • antiviral drugs, which can be oral or intravenous
  • skin treatments, such as gels or creams, that provide itch or pain relief
  • cool compresses, which can alleviate symptoms where the rash appears
  • over-the-counter pain medications
  • nerve blockers that reduce pain, which a doctor may inject into the spine or peripheral nerves
  • additional pain medicines
  • antidepressants or epilepsy medications

If anyone suspects that they have shingles, they should receive treatment as soon as possible. As soon as a person with HIV experiences new symptoms associated with shingles, they should seek medical attention.


A person can only develop shingles if they have had chickenpox. A person is more likely to develop shingles if their immune system is compromised, and this can include people with untreated HIV or stage 3 HIV.

People with fewer CD4 cells and higher HIV viral loads are more likely to develop shingles and have more severe complications. When the functioning of the immune system is reduced, it can also be more difficult to treat shingles.

If a person with HIV suspects that they have shingles, they should see their doctor as soon as possible to avoid or reduce the impact of complications.

Receiving treatment for HIV is the best way to boost the immune system and reduce the risk of other infections. With treatment, a person with HIV can have the same quality of life as a person without HIV.

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