Slide 7
Erosive HSV infection in an HIV-positive patient

In certain HIV-infected patients, an atypical HSV-related syndrome has been described [Fox PA, Barton SE, Francis N et al. Chronic erosive HSV infection of the penis: a possible immune reconstitution disease. HIV Medicine 1999;1:10–18]. Lesions were unresponsive to antiviral treatment that had previously been effective, and this may be the result of partial immune restoration following commencement of highly active antiretroviral therapy (HAART). Diagnostic biopsy as well as screening for STIs such as lymphogranuloma venerium, chancroid and syphilis must be performed in such complex cases. It is also recommended that management involves a specialist in infectious diseases, a genitourinary physician, a dermatologist and an urologist.