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herpes and hiv

Mar 8, 2008

I was diagnosed with HIV and Herpes in October. My first labs were good I thought 571 vl 10000. I started 1grm Valtrex and remained outbreak free for that entire time until recently. My next set of labs were a lot better 681 and 8000. I had thought that this was a secondary effect of treating herpes with valtrex. But two weeks ago, following an anal hpv treatment, I got an outbreak that just wont go away. I also got cold sores for the first time. They increased my valtrex to 2grams a day. It has been almost a week of taking this dose and it is still very irritating. Could valtrex just not be effective for me? Should I be concerned? My outbreaks are more of a nuisance than anything else. The thing I am most concerned about is keeping my cd4 and vl in check. Can I expect to get sporadic outbreaks even while taking valtrex and should I not worry that much about it?

Response from Dr. Holodniy

Although, your HIV numbers are pretty good, and most providers would not recommend starting HIV treatment, recurrent outbreaks of herpes, could be an indication for starting HIV treatment earlier. Additionally, you could have an acyclovir resistant strain of HSV and that may also be a reason why you are not responding to this treatment.

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