{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T07:38:04Z","timestamp":1792827484755,"version":"4.5.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T00:00:00Z","timestamp":1660003200000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Varicella-zoster virus (VZV) infection disproportionately affects people with HIV (PWH), primarily presenting as herpes zoster. However, VZV seroprevalence, its association with zoster, and clinical outcomes remain understudied in era of modern antiretroviral therapy (ART). We assessed VZV seroprevalence, rates of VZV illness, and associated health care costs in a large cohort of PWH over 20 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed retrospective chart reviews of patients followed at a regional HIV clinic from January 1, 2000, to December 31, 2020. Serological, immunization, clinical, and costing data were extracted from in-house databases. VZV-related inpatient admissions, emergency department (ED), and urgent care (UC) visits were identified using relevant International Classification of Disease (ICD-10) codes and validated where possible by 2 physicians. Health care utilization costs were adjusted to 2020 Canadian dollars.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 3006 PWH, VZV serology was available for 2628; of these, 2503 (95.2%) were seropositive. Only 39% of known seronegative patients were subsequently immunized for varicella. During 29\u2009768 years of patient follow-up, 38 hospitalizations and 138 ED\/UC visits due to VZV infection were identified. Most occurred in VZV-seropositive PWH &amp;lt;50 years of age (82%) who were unimmunized (99.2%) and not on ART (64.8%). Nearly 25% of hospitalizations were due to laboratory-confirmed VZV meningitis\/encephalitis. The average admission cost was CDN$33\u2009001; the total measured cost of VZV illness was CDN$1\u2009258\u2009718.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Despite ART and vaccines for chickenpox and shingles, VZV still caused significant costs and morbidity for PWH, occurring at younger ages and often as encephalitis\/meningitis. Supporting ART adherence may reduce VZV illness and hospitalization costs in PWH, and the cost-effectiveness of expanding shingles vaccine use warrants further study.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofac395","type":"journal-article","created":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T14:08:00Z","timestamp":1660054080000},"source":"Crossref","is-referenced-by-count":14,"title":["Seropositivity, Risks, and Morbidity From Varicella-Zoster Virus Infections in an Adult PWH Cohort From 2000\u20132020"],"prefix":"10.1093","volume":"9","author":[{"given":"Jason","family":"Zou","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Calgary , Calgary, Alberta , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hartmut B","family":"Krentz","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Calgary , Calgary, Alberta , Canada"},{"name":"Southern Alberta Clinic, Alberta Health Services , Calgary, Alberta , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raynell","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Calgary , Calgary, Alberta , Canada"},{"name":"Southern Alberta Clinic, Alberta Health Services , Calgary, Alberta , Canada"},{"name":"Department of Community Health Sciences, Cumming School of Medicine, University of Calgary , Calgary, Alberta , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda","family":"Beckthold","sequence":"additional","affiliation":[{"name":"Southern Alberta Clinic, Alberta Health Services , Calgary, Alberta , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Alberta Precision Labs, ProvLab Calgary , Calgary, Alberta , Canada"},{"name":"Department of Microbiology, Immunology &Infectious Diseases, University of Calgary , Calgary, Alberta , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M John","family":"Gill","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Calgary , Calgary, Alberta , Canada"},{"name":"Southern Alberta Clinic, Alberta Health Services , Calgary, Alberta , Canada"},{"name":"Department of Microbiology, Immunology &Infectious Diseases, University of Calgary , Calgary, Alberta , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,8,9]]},"reference":[{"key":"2022082217181685900_ofac395-B1","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1056\/NEJMcp1302674","article-title":"Clinical practice: herpes zoster","volume":"369","author":"Cohen","year":"2013","journal-title":"N Engl J Med"},{"key":"2022082217181685900_ofac395-B2","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1086\/510206","article-title":"Recommendations for the management of herpes 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perspective","volume":"4","author":"Kawai","year":"2014","journal-title":"BMJ Open"},{"key":"2022082217181685900_ofac395-B6","doi-asserted-by":"crossref","first-page":"80","DOI":"10.15585\/mmwr.mm7103a2","article-title":"Use of recombinant zoster vaccine in immunocompromised adults aged \u226519 years: recommendations of the Advisory Committee on Immunization Practices\u2014United States 2022","volume":"71","author":"Anderson","year":"2022","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2022082217181685900_ofac395-B7","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1093\/cid\/ciaa014","article-title":"Impact of a publicly funded herpes zoster immunization program on the burden of disease in Ontario, Canada: a population-based study","volume":"72","author":"Martins","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2022082217181685900_ofac395-B8","doi-asserted-by":"crossref","first-page":"331","DOI":"10.14745\/ccdr.v44i12a06","article-title":"What is new in the 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