Treatment of Recurrent Genital Herpes in People Living with HIV

People living with HIV who experience recurrent genital herpes represent a distinct clinical population requiring careful management. Immune status significantly influences the frequency and severity of herpes simplex virus reactivation in this group.

Clinical scenario: 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 lower CD4 cell counts. This increased recurrence burden shapes the treatment approach for this population.

Treatment approach

Suppressive antiviral therapy — using agents such as aciclovir or valaciclovir — forms the basis of management. In people living with HIV where standard suppression does not adequately control disease, a specific adjustment to the antiviral regimen is recommended…

Full regimen details, dosing, and decision algorithm available in the protocol →

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References

DOI: 10.1111/jdv.20450

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 <50 per mm³.

If these options do not adequately control disease, then the first option should be to double the dose.

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