In children, epidemic primary infection with VZV manifests as chickenpox. One suggestion is that every person who has had chickenpox harbors latent virus; molecular analyses of DNA have shown that VZV infection in adults represents reappearance of the childhood virus infection. Of all people who live to be 85 years of age, about half will have an attack of zoster, and about 10% of this affected population will have at least two attacks. One study found 100 cases per 100,000 person-years among people aged between 15 years and 35 years, with an increase in each decade to 450 cases per 100,000 by age 75 years. The proportion of Americans older than 65 years is increasing, so rates of VZV infection and its associated complications will also increase (22). The lifetime risk of VZV infection is estimated at between 10% and 20%. Compared with persons who are seronegative for HIV, persons who are seropositive for HIV have a higher frequency of VZV infection. This higher frequency of VZV infection can be expected for any population with immunodeficiency.
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