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Disseminated VZV IV Aciclovir — SCE Infectious Diseases MCQ

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EasyImmunocompromised HostDisseminated VZV IV AciclovirSCE Infectious Diseases

A 45-year-old man with HIV develops multidermatomal herpes zoster (involving T4, T5, and T6 dermatomes) with visceral dissemination (hepatitis). His CD4 is 80 cells/µL. What treatment is required?

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Correct answer: B — IV Aciclovir 10 mg/kg TDS for at least 7 days (or until all lesions have crusted) — multidermatomal/disseminated VZV in immunosuppression requires IV therapy

Multidermatomal zoster (≥2 non-contiguous dermatomes) or any visceral/disseminated VZV in immunocompromised patients requires IV Aciclovir at full immunosuppressed dosing (10 mg/kg TDS adjusted for renal function). Oral therapy is insufficient for disseminated disease.

Reference: BHIVA 2022 – OI guidelines; NICE CKS 2024 – Shingles