Human immunodeficiency virus (HIV) infection is associated with a wide spectrum of systemic and ocular infectious diseases. Little is known about its association with herpes simplex keratitis (HSK) in this geographical region (South India). A retrospective study was undertaken to analyze this association in a cohort of 30 virologically proven recurrent HSK cases. Laboratory methods included herpes simplex virus (HSV) isolation, HSV antigen detection and tear secretory IgA or HSV DNA detection while commercial ELISA kits detected HIV infection. The rationale behind the HIV screening was to assess the role of HIV with increased HSK recurrences. Confirmed HIV seropositivity was 16.7% in recurrent HSK cases as against 3.3% in the matched first-episode HSK cases (p < 0.05, Fisher's exact test). Our observations on the features of herpetic keratitis in HIV-proven patients, though based on a small number of cases, raise the question whether the immunological abnormalities associated with HIV/AIDS may affect the clinical course of HSK.