In Cases of Weakened Immunity
In people with HIV and other immunological disorders, both chickenpox and shingles can take longer to clear, up to four weeks in some cases. What’s more, shingles can recur in such people.
Treatment of shingles can include the antiviral drugs valacyclovir or famciclovir. These drugs can speed the healing of lesions and sometimes cause a reduction in pain and the risk for post-herpetic neuralgia.
Although vaccines are licensed to reduce the risk of developing chickenpox and shingles, they contain weakened but live virus. People with HIV infection (or parents of children with HIV) should consult an infectious disease or HIV specialist about whether it is safe for them (or their children) to receive these vaccines. If someone with a weak immune system is in contact with a person infected with chickenpox, it is important that they contact their health care provider to find out if they need treatment to prevent developing chickenpox themselves.
Two candidate shingles vaccines are being tested for possible use in people with immunological disorders. These vaccines are:
- a heat-treated vaccine -- this contains virus that has been treated with heat so that it cannot cause infection. However, it can stimulate immunity to VZV. This vaccine is being developed by Merck.
- a subunit vaccine -- this contains a protein from VZV that is coupled with a protein derived from bacteria. The purpose of the bacterial protein is to stimulate the immune system when it is exposed to the protein from VZV, amplifying the immune response to VZV. Neither the protein from VZV nor the protein from bacteria can cause infections. This vaccine is being developed by GlaxoSmithKline.
Preliminary results from clinical trials of both of these vaccines suggest that they are safe and cause immunity to VZV.
About the chickenpox vaccine
About the shingles vaccine
We thank infectious disease specialist Jason Brophy, MD, for his helpful comments, expert review and research assistance.
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