Prevalence of Varicella-Zoster Virus Infections in Immunocompromised Patients at a Teaching Hospital in Anambra State

Varicella-zoster virus (VZV) causes primary varicella (chickenpox) and can reactivate as herpes zoster (shingles) in immunocompromised individuals, leading to severe complications including encephalitis and pneumonitis. This study investigates the prevalence of VZV-related clinical presentations among immunocompromised patients, including those with HIV, malignancies, and post-transplant status, at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, South East Nigeria. A retrospective cross-sectional study will review inpatient and outpatient records over a five-year period (2019 to 2024), extracting data on confirmed VZV diagnoses based on clinical presentation and laboratory findings. Patients will be stratified by immunosuppression type, VZV complication severity, and antiviral treatment received. Data analysis will use descriptive statistics and logistic regression to identify risk factors for VZV complications. The sparse Nigerian literature on VZV in immunocompromised adults suggests an underdiagnosis problem, partly attributed to misclassification of zoster presentations. Findings will quantify the VZV burden at a major tertiary centre in Anambra State, identify gaps in antiviral treatment access, and inform clinical protocols for VZV prophylaxis in high-risk inpatient populations. This study supports efforts to strengthen clinical virology diagnostic capacity in South East Nigeria and contributes to evidence for introducing VZV vaccination in adult immunisation schedules. Keywords: varicella-zoster virus, immunocompromised patients, herpes zoster, Anambra State, prevalence