In people living with HIV, genital herpes follows a more complex course than in immunocompetent individuals. Recurrences tend to be more frequent, and the clinical picture can be more persistent — making an evidence-based suppressive strategy an important part of management.
Both clinical and subclinical reactivations of genital herpes are more frequent in people living with HIV and may lead to persistent and progressive anogenital mucocutaneous lesions, especially with CD4 cell counts below 50 per mm³.
The recommended strategy is daily oral HSV suppressive antiviral therapy. The full protocol details the specific agents and their regimens.
DOI: 10.1111/jdv.20450