Acyclovir prophylaxis for herpes tester in HIV-positive patients.

We studied 39 AIDS patients from 1989 to 1996, with previous history of her pes tester. Twelve of them received acylovir (ACV) secondary prophylaxis. T here were 31 males and 8 females, mean age 33,9 years (19-60) during first herpes tester. Transmission was sexual in 71,8%. Among these 39 patients, 7 8 herpes tester episodes occured. Median CD4 lymphocytes was 18/mm(3) (0-23 2) among the 12 patients with ACV prophylaxis. Mean posology of ACV was 2 4 00 mg (1 600-4 000) per day, during mean 10 months (median 4 months). ACV p rophylaxis was used because of high frequence of herpes tester (more than 4 ) (4 cases), neurologic complications in 4 cases (1 myelitis, myeloradiculi tis, 1 vascularitis and I meningo-encephalitis), disseminated herpes tester in 4 cases and one hyperalgic tester. Ten from these 12 patients occured n o tester recurrence. Among patients without prophylaxis, tester recurrences were more frequent at 12 months (68% versus 22% among patients with prophy laxis). This prophylaxis seems to be interesting, particulary in deep immun ocompromised patients (CD4< 50/mm(3)) with serious herpes tester or frequen t recurrences (more than 4). However, since protease inhibitors treatments, tester incidence is decreasing in HIV + patients. This prophylaxis will pr obably be less usefull than before.