This is the case of a black African woman who presented with three distinct episodes of herpes simplex virus (HSV) infection unresponsive to first-line therapy. Clinical and virological resistance to aciclovir therapy was demonstrated, and although the first two episodes manifested as the deep ulceration often associated with HIV/HSV coinfection, the third was an atypical hypertrophic lesion. This is despite her CD4 count being persistently above 300 and there being no previous diagnosis of AIDS.
"Most HIV-positive patients are coinfected with herpes simplex virus type 2. Some of these patients may present uncommon clinical manifestations, such as hypertrophic genital lesions . Nodules are rare in immunocompromised patients and there have been few reports in either sex   . A 41-year-old woman presented with a painless hypertrophic vulvar lesion that had been infected for over 6 months. "
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 08/2009; 107(3):255. DOI:10.1016/j.ijgo.2009.07.003 · 1.54 Impact Factor
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