Prevention

Chronic antiviral suppressive therapy is suggested for HIV-seropositive people whose herpetic disease is poorly controlled.^[44],^[45] Valaciclovir 500 mg twice a day or acyclovir 400 mg twice a day is recommended for suppressive therapy.^[46] In addition, people with HIV and HSV-2 co-infection who are sexually active should be advised of the association between HSV-2 reactivation and mucosal HIV-1 shedding. Although the topical use of tenofovir to inhibit HIV-1 transmission demonstrated antiherpetic activity, the reduction of risk for HSV-2 transmission was reported to be around 50%.^[47] Suppressive acyclovir did not decrease the risk of HSV-2 transmission from persons with HSV-2/HIV-1 infection to susceptible partners.  Therefore, more effective prevention strategies to reduce HSV-2 transmission from persons with HIV-1–infection are required.^[48]