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Reccurring Herpes Infection
Oct 8, 2003

I am not on any ARV treatment because I can no longer afford what I was presribed after being on Triomune for one month, 4 months ago when I had to stop its use as it induced hepatitis.I have now got very frequently recurring herpes infection, at least twice a month, even after acyclovir treament each time they appear. Is there a stronger and more effective medication ofr herpes or is acyclovir it.

Response from Dr. Aberg

I am assuming that you are taking acyclovir only at the time you develop herpes. Anyone with recurrent herpes, should consider taking acyclovir daily to prevent recurrent infections. Have you tried that? Alternatively, one could also take famciclovir or valacyclovir. Valacyclovir has been associated with the development of a syndrome that including lowering of the platelets (blood cells responsible for clotting) so this would have to be considered as part of the risk vs benefit of once daily vs the twice daily acyclovir.

Depending where you live, your provider may be able to send a culture from one of your lesions and perform susceptibility tests on the herpes to see if it is resistant to acyclovir. If it is acyclovir resistant, treatment is much more difficult as one would need to use medicines that are available in intravenous (through a vein) forms only.

The first thing I would do is take acyclovir every day to see if it prevents or decreases the number of recurrences. I do not know what your financial situation is or where you live, but please ask your provider if there are any compassionate programs or other ways to access meds to treat your HIV. Having your HIV infection controlled will reduce your outbreaks of herpes as well as prolong your life if your CD4 count is of the range where you need treatment.


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