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Is valacyclovir standard prophylaxis?
Jun 2, 2006

I have been battling a very bad case of shingles on my face for the past two months. Immediately the day of the outbreak, my doctor put me on valacyclovir (Valtrex) 1000mg 4xdaily. I have been HIV+ since 1996, and have never had a herpes-related incident.

Recently I was talking with a colleague who has been HIV+ a lot longer than I , and he was shocked that I had not been taking Valtrex from the very day I was diagnosed positive. He says it is standard procedure, a standard part of every HAART regime. I have, and have had good HIV savy physicians, and I had never heard this. Is he right? Should I be concerned, or even angry that I wasn't taking anti-herpes medication all this time as a prophylaxis?

Concerned in NYC

Response from Dr. Wohl

Your friend is not correct. Valacyclovir is not routinely prescribed to HIV+ persons without a history of recurrent herpes outbreaks. I reserve use of this medication as a prophylaxis to those who have outbreaks every month or two.

Shingles lesions should respond well to valacyclovir and should not last 2 months. I wonder why you still have lesions. Were they located only on one side of your face - as is typical? Could they be super-infected with bacteria? The bubbles that you had initially really should be gone if this is shingles.

DW



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