Valacyclovir Decreases Plasma HIV-1 RNA in HSV-2 Seronegative Individuals: A Randomized Placebo-Controlled Crossover Trial

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
Christophe VanpouilleLeonid Margolis

Abstract

Acyclovir (ACV), a highly specific anti-herpetic drug, acts as a DNA chain terminator for several human herpesviruses (HHVs), including HHV-2 (HSV-2), a common human immunodeficiency virus (HIV)-1 co-pathogen. Several trials demonstrated that HSV-2 suppressive therapy using ACV or its prodrug valacyclovir (valACV) reduced plasma HIV-1 viral load (VL) in HIV-1/HSV-2 coinfected persons, and this was proposed to be due to a decrease in generalized immune activation. Recently, however, we found that ACV directly suppresses HIV-1 ex vivo in tissues free of HSV-2 but endogenously coinfected with other HHVs. Here, we asked whether valACV suppresses VL in HIV-1 infected HSV-2-seronegative persons. Eighteen HIV-1 infected HSV-2-seronegative individuals were randomly assigned in a double blind placebo-controlled, crossover trial. Eligible participants had CD4 cell counts of ≥500 cells/µL and were not taking antiretroviral therapy. Subjects in group A received 12 weeks of valACV 500 mg given twice daily by mouth followed by 2 weeks of a no treatment washout and then 12 weeks of placebo; subjects in group B received 12 weeks of placebo followed by 2 weeks of no treatment washout and then 12 weeks of valACV 500 mg twice daily. HIV-1 VL in p...Continue Reading

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Citations

Mar 26, 2016·Journal of Laboratory Physicians·Arshi Munawwar, Sarman Singh
Mar 10, 2015·The Journal of Infectious Diseases·Sara GianellaDavey M Smith
Feb 22, 2017·Scientific Reports·Paula OrdonezJonathan P Stoye
Jun 11, 2017·Sexually Transmitted Infections·Vishalini SivarajahDarrell Hs Tan
Oct 31, 2018·The Journal of Antimicrobial Chemotherapy·Darrell H S TanUNKNOWN VALIDATE Study Group

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