Dear Doctor,facing my 15th year with HIV, I am more careful to therapy side effects rather than AIDS itself. Keeping my VL mostly <50 and CD4>800 with sustiva/ kaletra/ ziagen and a quite normal life, I am very upset when a common herpes,at least once a year, leaves behind, for months after the herpes recovery, an ulcer secreting serum on my coccygeal area,insensible to any therapy and ruining my intimate life. Last time it disappeared in a single day (lasting 4 months) following a violent onset of flu fever.Any suggestion(already 2 months this time...)?

I have observed a similar problem in a small number of my own patients. I often put them on long-term suppressive therapy with 500-1000mg Valtrex per day (or acyclovir) with generally good results. KH