Abstract Herpes zoster virus infections occur in persons with decreased cellular immunity. A 45-year-old man is described who presented with disseminated herpes zoster as the initial manifestation of his human immuno-deficiency virus infection. Disseminated herpes zoster virus infections have been reported in human immunodeficiency virus-seropositive patients. Similar to disseminated herpes zoster virus infections that occur in immunosuppressed patients seronegative for human immuno-deficiency virus, an increased morbidity and responsiveness to acyclovir is observed. In contrast, the morphology of the skin lesions and the clinical course have been more severe, and the mortality has been increased. Visceral involvement has not been described.