This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Viral infections, Subject name: Dental
[{'content': 'Which may be the first indication of clinical immunodeficiency in HIV infected patients? \nSelect and explain. \nA. Vitiligo, B. Hairy Leukoplakia, C. Lupus vulagris, D. Herpes Zoster', 'role': 'user'}, {'content': 'Answer: D \nExplanation: Reactivation syndrome of varicella-zoster virus indicates a modest decline in immune function and may be the first indication of clinical immunodeficiency. Reactivation of herpes zoster (shingles) is seen in 10-20% of patients with HIV infection. Valacyclovir, acyclovir, or famciclovir is the TOC. Foscarnet may be of value in patients with acyclovir-resistant virus.', 'role': 'assistant'}]