Dr Kennedy Anyachebelu, an independent consultant with the Clinton Health Access Initiative (CHAI), has cautioned against linking shingles, popularly referred to in some communities as the ‘Calabar belt’, directly to HIV, describing such an association as medically inaccurate.
Anyachebelu said the condition, medically known as herpes zoster or shingles, is caused by the varicella-zoster virus, the same virus responsible for chickenpox.
He spoke on the sidelines of a two-day national training of media personnel on lenacapavir organised by the Institute of Human Virology Nigeria in collaboration with the National Agency for the Control of AIDS.
He explained that after a person recovers from chickenpox, the virus can remain dormant in nerve cells for years before becoming reactivated and causing shingles.
According to him, the reactivation can produce pain, burning, tingling, or itching in a particular area, followed by clusters of fluid-filled blisters, usually appearing on one side of the body or face.
He said the term ‘Calabar belt’ is commonly used in some Nigerian communities to describe the characteristic band-like pattern of the shingles rash, but stressed that the rash does not have to form a complete belt around the body.
‘The belief that this condition, sometimes called the ‘Calabar belt,’ is automatically a sign of HIV is not medically correct,’ Anyachebelu said.
He explained that HIV can increase a person’s risk of developing shingles because HIV can weaken the immune system but added that HIV is only one of several factors associated with the condition.
‘Shingles does not automatically mean HIV. People with weakened immunity may be more susceptible, but there are several reasons why someone can develop shingles,’ he said.
Anyachebelu identified advancing age, certain cancers, organ transplantation, and the use of medicines that suppress the immune system, among other factors that can increase the risk of shingles.
He said the condition could occur in people who do not have HIV and urged the public not to stigmatise individuals who develop the rash.
The consultant also warned against the belief that a shingles rash becomes fatal if the two ends of the so-called belt meet around the body.
According to him, there is no medical basis for the belief that the meeting of the two ends of the so-called belt rash determines whether a patient will survive.
He explained that shingles typically follows the distribution of an affected nerve and usually appears on one side of the body.
‘What matters medically is not whether the rash meets around the body. What matters is the severity of the infection, the patient’s immune status, the location of the rash, and whether complications develop,’ he said.
Anyachebelu advised people who develop symptoms suggestive of shingles to seek medical attention early.
He said antiviral medicines, including acyclovir, valacyclovir, and famciclovir, may be prescribed by healthcare professionals and are most effective when started early in the illness.
He discouraged self-treatment and warned against cutting, burning, puncturing, or applying unproven substances to the blisters. Such practices, he said, could cause additional skin injury, introduce bacterial infection, and delay appropriate treatment.
Anyachebelu further said the pain associated with shingles could sometimes begin before the rash becomes visible.
He explained that patients may experience burning, tingling, itching, or severe pain in an area of the body before the characteristic blisters appear.
He added that shingles is not simply a skin condition because the virus becomes reactivated in nerve tissue and travels along the affected nerve to the skin.
The doctor further warned that the pain could persist even after the rash had disappeared.
He identified postherpetic neuralgia, a condition in which nerve pain continues after the shingles rash has healed, as one of the complications that can occur, particularly among older adults.
Anyachebelu also urged people to seek urgent medical attention when the rash affects the face or area around the eye, noting that shingles involving the eye can lead to serious complications, including vision problems.
On transmission, he explained that a person cannot catch shingles itself from another person.
He said, however, that someone with active shingles blisters can transmit the varicella-zoster virus to a person who has never had chickenpox or been vaccinated against it, potentially causing chickenpox in that person.
He therefore advised patients with active shingles to keep the rash covered, avoid touching or scratching the blisters, and practise good hand hygiene.
He also recommended avoiding direct contact with vulnerable people, including newborns, individuals with weakened immune systems, and pregnant women who are not immune to chickenpox.
Anyachebelu said vaccination could help reduce the risk of shingles and its complications, while recommended vaccination against chickenpox can reduce the risk of acquiring varicella-zoster virus infection.
He urged Nigerians to seek proper medical evaluation when they develop a painful or unusual blistering rash rather than relying on myths associated with the ‘Calabar belt’.
‘Shingles can be painful and can sometimes lead to complications, but it should not be surrounded by unnecessary fear or HIV stigma. The important thing is to recognise the symptoms, seek medical care early, and understand that having shingles does not, by itself, mean that a person has HIV,’ he said.