A groundbreaking study presented at IDWeek 2025 has revealed a potential game-changer for people living with HIV (PLWH). The research, conducted by Dr. Ali Dehghani and colleagues, highlights the significant benefits of zoster vaccination in this high-risk population. But here's where it gets controversial: the findings suggest that this vaccine could not only prevent shingles but also reduce mortality rates and cardiovascular risks.
The study, utilizing a large national database, matched 3,146 participants aged 50 and above with HIV, half of whom had received the recombinant zoster vaccine. The results were astonishing: vaccinated individuals experienced a 46% lower risk of all-cause mortality and a 39% lower risk of major adverse cardiovascular events (MACE) compared to their unvaccinated counterparts.
Dr. Dehghani and the team wrote, "People living with HIV face elevated risks due to persistent immune activation. Herpes zoster, common in this population, may further exacerbate these risks."
The findings align with previous research indicating that varicella-zoster virus reactivation may contribute to vascular damage in PLWH. A retrospective Italian cohort study supported this, showing that PLWH with a history of herpes zoster had a significantly higher likelihood of ischemic events.
Despite these compelling results, vaccine uptake remains limited. A study in Belgium found low awareness among PLWH about herpes zoster and its connection to varicella. Only a third of the surveyed patients knew of this link.
The Advisory Committee on Immunization Practices recommends two doses of the recombinant zoster vaccine (RZV) for immunocompromised adults, including PLWH. However, the new study's findings suggest that expanding RZV use could bring about a dual benefit: reducing shingles incidence and improving cardiovascular health and survival rates.
And this is the part most people miss: the potential for a simple vaccine to not only prevent a painful condition but also improve overall health and longevity for PLWH. It's a powerful reminder of the importance of vaccination and its role in managing chronic conditions.
So, what do you think? Is this a game-changer for PLWH? Should more emphasis be placed on educating and encouraging vaccination in this population? We'd love to hear your thoughts in the comments below!
