Treating Herpes May Slow HIV in Co-Infected Patients

Study shows benefit of suppressing herpes virus before starting antiretroviral therapy
By Jane Parry
HealthDay Reporter

MONDAY, Feb. 15 (HealthDay News) -- In patients co-infected with HIV-1 and herpes simplex virus type 2, treating the herpes infection with acyclovir likely delays the progression of HIV, according to a study published online Feb. 15 in The Lancet.

Jairam R. Lingappa, M.D., of the University of Washington in Seattle, and colleagues conducted a study of 3,381 heterosexual people with both HIV-1 and herpes simples virus type 2, none of whom were on antiretroviral therapy at the start of the study. The participants had a median CD4 cell count of 462 cells per µL and were randomized to receive either 400 mg of acyclovir twice a day or placebo, and were then followed up for 24 months.

The researchers defined HIV disease progression as the first occurrence of fewer than 200 CD4 cells per µL, initiation of antiretroviral therapy or non-trauma related death. They found that the risk of HIV-1 progression was 16 percent lower in the participants taking acyclovir. While 324 participants in the placebo group reached the threshold cell count, this happened to only 248 people in the acyclovir group, the investigators found.

"Efforts should be stepped up to ensure that HIV-infected patients in low-income and middle-income countries who have frequent recurrences of genital herpes or severe genital herpes receive suppressive therapy with acyclovir, as recommended in industrialized countries," write the authors of an accompanying editorial.

Several authors reported receiving grant support from pharmaceutical companies, including GlaxoSmithKline, Astellas, and Antigenics.

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