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HIV + herpes
Jul 22, 2006

I love this website doc. I was diagnosed HIV + sept 2005 having just zero converted with usualo flu systems/rash. My counts have stablised to around cd4 600 with low viral load 14000 last count. I recently have had group spots in one area beside my cheek adjacent to my nose. Skin specialist said prob herpes. Now taking valtrax 3 times daily and after week are now receding. He suggests to prevent them coming back, take one Valtrax pill a day long term. Can I still remain off antiviral therapy with herpes? thks so much!

Response from Dr. Horwath

You should discuss the decision to start antiretroviral medications (HAART) with your HIV specialist. The current guidelines recommend starting HAART before the CD4 counts falls below 200. In asymptomatic individuals, it is not recommended to start when the CD4 count is above 350. In those with CD4 count between 200 and 350, the decision is based upon the viral load (> 100,000) and the presence of symptoms, such as unexplained fever or diarrhea > 2-4 weeks, oral candidiasis, or >10% unexplained weight loss.

For people with an AIDS-defining illness, treatment may be started at any CD4 count. For Herpes infection, this decision may be influenced by the severity of the infection and should be individualized. Talk to your doctor about it.



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