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| |  Progression of HIV Appears to Be Slowed by Acyclovir: Presented at IAS By Ed Susman CAPE TOWN, South Africa -- July 23, 2009 -- Patients with HIV who are coinfected with herpes simplex virus-2 (HSV-2) could slow their rate of immune system decline if they are treated with acyclovir, researchers stated here at the 5th International AIDS Society (IAS) Conference on HIV Pathogenesis, Treatment and Prevention. "Herpes simplex virus-2 suppression reduces the risk of HIV disease progression," said Jairam R. Lingappa, MD, Global Health and Medicine, University of Washington, Seattle, Washington, on July 22. Dr. Lingappa calculated a statistically significant 17% to 19% decrease in the risk of a patient having their CD4+ count drop to a level where antiretroviral therapy should be initiated. In the Partners in Prevention HSV/HIV Transmission study, researchers enrolled 2,284 HIV-positive women and 1,097 HIV-positive men who were in a regular sexual relationship with a partner who was not HIV-negative. The couples were counselled on how to avoid infection and were either treated with acyclovir 400 mg BID or a placebo. The incidence of reaching the composite endpoint of antiretroviral initiation or death occurred at the rate of 11.3 times per 100 person-years among those on acyclovir and 13.6 times a year for those on a placebo -- a relative risk reduction of 17% (P = .03). Dr. Lingappa said that a subgroup analysis did not show differences between the groups for outcomes based on sex, baseline CD4 cells or baseline HIV-RNA levels. Researchers also observed a nonsignificant trend indicating that patients did better if they adhered to their medical regimen more than 90% of the time when compared with those that were not as compliant with therapy (P = .13). In looking at the endpoints separately, researchers found a 17% reduction in the risk of reaching a CD4+ cell count of 200 copies (P = .03); a 19% reduction in the risk of reaching a CD4+ cell count of 350 copies (P = .002); a 19% reduction in the risk of needing to initiate antiretroviral therapy (P = .05); and a 24% reduction in the risk of death (P = .29). Funding for this study was provided by the Bill and Melinda Gates Foundation. [Presentation title: Daily Acyclovir Delays HIV-1 Disease Progression Among HIV-1/HSV-2 Dually-Infected Persons: A Randomized Trial. Abstract WELBC102]
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