The efficacy of anti-herpetic drugs in decreasing HIV disease progression has not been clarified. We studied a cohort of 126 HIV-positive individuals with known date of seroconversion who were HSV-2-seropositive to determine if progression to AIDS was influenced by treatment with acyclovir. In the multivariate analysis, being homosexual and low CD4 count were associated with a faster progression to AIDS, whereas treatment with acyclovir showed a 37.0% protective effect compared to those who did not receive it when antiretroviral treatment was not included in the model. When including antiretroviral therapy, the protective effect of acyclovir decreased to 9.0% and that of antiretroviral therapy was 43.0% for monotherapy and 36.0% for double therapy, suggesting that most of the protective effect of acyclovir in the previous model was due to antiretroviral therapy. In conclusion, treatment with acyclovir does not seem to prolong significantly survival to AIDS among HIV-positive individuals who are HSV-2-infected.
References
1.
BarinskiiI.F., NosikD.N., Kal'novS.L., NikitinaA.A., L'vovM.D., PetrovaM.S., & TsibezovV V.Activation of viral reproduction in a mixed infection with human immunodeficiency virus and herpes viruses. Vopr Virusol1994; 39: 223–226.
2.
HengM.C., HengS.Y., & AllenS.G.Co-infection and synergy of human immunodeficiency virus-1 and herpes simplex virus-1. Lancet1994; 343: 255–258.
3.
GoldenM.P., KimS., HammerS.M., LaddE.A., SchafferP.A., DeLucaN., & AlbrechtM.A.Activation of human immunodeficiency virus by herpes simplex virus. Journal of Infectious Diseases1992; 166: 494–499.
4.
MoscaJ.D., BednarikD.P., RajN.B., RosenC.A., SodroskiJ.G., HaseltineW.A., & PithaP.M.Herpes simplex virus type-1 can reactivate transcription of latent human immunodeficiency virus. Nature1987; 325: 67–70.
5.
RandoR.F., PellettP.E., LuciwP.A., BohanC.A., & SrinivasanA.Transactivation of human immunodeficiency virus by herpesviruses. Oncogene1987; 1: 13–18.
6.
MoleL., RipichS., MargolisD., & HolodniyM.The impact of active herpes simplex virus infection on human immunodeficiency virus load. Journal of Infectious Diseases1997; 176: 766–770.
7.
SuligoiB., DorrucciM., VolpiA., AndreoniM., PezzottiP., RezzaG. and the Italian Seroconversion Study. Absence of an effect of HSV-2 infection on HIV disease progression: data from a cohort of HIV-positive individuals with known date of seroconversion. AIDS2001; 15: 133–135.
8.
IoannidisJ.P., CollierA.C., CooperD.A., CoreyL., FiddianA.P., GazzardB.G., GriffithsP.D., Contopoulos-IoannidisD.G., LauJ., PaviaA.T., SaagM.S., SpruanceS.L., & YouleM.S.Clinical efficacy of high-dose acyclovir in patients with human immunodeficiency virus infection: a meta-analysis of randomized individual patient data. Journal of Infectious Diseases1998; 178: 349–359.
9.
TorresR.A., NeatonJ.D., WentworthD.N., BarrM.R., AbramsD., ShererR., WardT., & SampsonJ.Acyclovir use and survival among human immunodeficiency virus-infected patients with CD4 cell counts of <500/mm3. The Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA). Clinical Infectious Diseases1998; 26: 85–90.
10.
RezzaG., DorrucciM., PezzottiP., LazzarinA., AngaranoG., SiniccoA., ZerboniR., AiutiF., PristeràR., GafaS., CastelliF., SalassaB., BarbaneraM., CanessaA., OrtonaL., RicchiE., VialeP., TirelliU., ZaccarelliM., & AlliegroB.The seroconversion study on the natural history of HIV infection. In HIV Epidemiology: Models and Methods. Edited by NicolosiA.1994; pp. 279–291. New York: Raven Press, Ltd.
11.
AshleyR.L., WaldA., & EagletonM.Premarket evaluation of the POCkit HSV-2 type-specific serologic test in culture-documented cases of genital herpes simplex virus type 2. Sexually Transmitted Diseases2000; 27: 266–269.
12.
CoutinhoR.A.Some aspects of the natural history of HIV infection. Tropical Medicine and International Health2000; 5.
