BACKGROUND In Manipur, a state in northeast India bordering Myanmar, within one year of reports of a high human immunodeficiency virus (HIV) seroprevalence among young injecting drug users, there has been a rapid spread of HIV infection in the general population. METHODS Since 1990 our unit, together with the Medical Directorate, Government of Manipur, has studied different aspects of this epidemic, especially the natural history of HIV in this setting. RESULTS Here we report the first case of herpes zoster in a 14-month-old HIV-positive baby (diagnosed by the polymerase chain reaction). The case was referred to our clinic by one of our patients residing in the same locality as the child and presently working as a counsellor in a drug detoxification-cum-rehabilitation centre at Imphal, Manipur. Dual infection of HIV and herpes zoster was also found in several other members of the same family. CONCLUSIONS This report of perinatally acquired HIV infection in an environment of injecting drug users in India might help in understanding the course of paediatric HIV infection here.