Overview of shingles (herpes zoster)

Shingles (herpes zoster) is caused by reactivation of varicella zoster virus (VZV)National Centre for Immunisation Research and Surveillance (NCIRS), 2022. It is uncommon in childhood and incidence increases with ageSchmader, 2018. Shingles occurs more frequently in patients with immune compromise, who are more likely to develop disseminated disease.

Shingles is usually a self-limiting infection lasting 10 to 15 daysNational Centre for Immunisation Research and Surveillance (NCIRS), 2022. It is characterised by a painful rash that presents with blisters in a dermatomal distribution on an erythematous base. The blisters erupt over a week and then heal over 2 weeks.

Patients with undiagnosed HIV infection may present initially with shingles. Shingles is an indicator condition for HIV testing1. If shingles is identified, offer HIV testing, regardless of whether the patient has behavioural or epidemiological risk factors for HIV infection2.

For information on the use of zoster vaccine see the Australian Immunisation Handbook.

1 Indicator conditions for HIV testing are conditions that are seen in people with HIV infection (including undiagnosed infection), conditions that share a transmission route with HIV (eg sexually transmissible infections), or conditions for which management is altered in people with HIV infection (eg tuberculosis).Return
2 In patients who need to be started on therapy for HIV, see Shingles in adults with HIV infection for advice on starting antiretroviral therapy.Return