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April 26, 2024

Ralph is a 50-year-old cisgender man with a past medical history of HIV currently treated with abacavir/dolutegravir/lamivudine

Ralph is a 50-year-old cisgender man with a past medical history of HIV currently treated with abacavir/dolutegravir/lamivudine (ABC/DTG/3TC). His last CD4 count was 480 cells/mm3, and his last viral load was undetectable about 3 months ago. Last year, he was diagnosed with herpes simplex virus-2 (HSV-2) after noting painful penile lesions. He took valacyclovir 1 g orally twice daily for 10 days with resolution and complete healing. He has had four additional similar episodes within the past year, some of which have resolved without treatment. He now presents to your clinic, stating he is having recurrent symptoms which started a few days ago. Physical exam reveals penile vesicular lesions with an erythematous base. He asks if there is anything that can be done to reduce the frequency of symptoms. After you prescribe treatment for this recurrence, what would you prescribe for suppression?

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