PREVENTION OF RECURRENT HERPES-SIMPLEX VIRUS (HSV) INFECTIONS IN HIV-INFECTED PERSONS

The purpose of this study was to determine the frequency of HSV infect ions and recurrences among HIV-infected patients and to examine differ ent regimens for suppression of HSV recurrence. A randomized retrospec tive chart review of HIV-infected patients ata public hospital in Los Angeles County was conducted. We reviewed 224 patients' charts; 26 per cent had AIDS based on the 1987 CDC definition. HSV infection was docu mented as a clinical event in 51 records (23 percent). Patients with a n AIDS diagnosis had a greater incidence (53 percent) of HSV infection s than did those with a diagnosis of symptomatic or asymptomatic HIV i nfection (p < 0.001, Fisher's exact test). Recurrences of HSV occurred in 26 (51 percent) of the 51 HSV-infefted persons during a period of 1042 patient months. Eighteen patients who had received acyclovir supp ression at 600 mg/day had three HSV recurrences in 382 patient months, whereas 14 who received 400 mg/day had eight recurrences in 282 patie nt months (p = 0.02). HSV infections occur in 23 percent of HIV-infect ed patients, increasing to 53 percent in AIDS patients. Acyclovir supp ression prevents recurrent HSV, and a dosage of 600 mg/day is more eff ective than 400 mg/day.