Valacyclovir Decreases Plasma HIV-1 RNA in HSV-2 Seronegative Individuals: A Randomized Placebo-Controlled Crossover Trial.
In: Clinical Infectious Diseases, Jg. 60 (2015-06-01), Heft 11, S. 1708-1714
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Zugriff:
Background. 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 copathogen. 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. Methods. 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. Results. HIV-1 VL in plasma of patients treated with valACV 500 mg twice daily for 12 weeks was reduced on average by 0.37 log10 copies/mL. Conclusions. These data indicate that the effects of valACV on HIV-1 replication are not related to the suppression of HSV-2-mediated inflammation and are consistent with a direct effect of ACV on HIV-1 replication. [ABSTRACT FROM AUTHOR]
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Valacyclovir Decreases Plasma HIV-1 RNA in HSV-2 Seronegative Individuals: A Randomized Placebo-Controlled Crossover Trial.
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Autor/in / Beteiligte Person: | Vanpouille, Christophe ; Lisco, Andrea ; Grivel, Jean-Charles ; Bassit, Leda C. ; Kauffman, Robert C. ; Sanchez, Jorge ; Schinazi, Raymond F. ; Lederman, Michael M. ; Rodriguez, Benigno ; Margolis, Leonid |
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Zeitschrift: | Clinical Infectious Diseases, Jg. 60 (2015-06-01), Heft 11, S. 1708-1714 |
Veröffentlichung: | 2015 |
Medientyp: | academicJournal |
ISSN: | 1058-4838 (print) |
DOI: | 10.1093/cid/civ172 |
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