Do you recommend to continue acyclovir to prevent HSV infection in an HIV patient with CD4 count more than 200 and with high viral load?  

The intent of this question isn't clear. Are you considering treatment of a person to prevent acquisition of HSV? Or to prevent transmission by an infected patient? The wording sort of implies the latter, so that scenario first. There are no data that document efficacy of antiherpetic therapy (acyc...