Herpes Simplex Virus Suppressive Therapy Decreases Plasma and Genital HIV-1 Levels in HSV-2/HIV-1 Co-infected Women: A Randomized Placebo-Controlled Cross-Over Trial

摘要

A randomized cross-over trial of HSV-2 suppressive therapy was conducted among 20 HSV-2/HIV-1 co-infected Peruvian women not on antiretroviral therapy. Participants were assigned valacyclovir 500 mg twice daily or placebo for 8 weeks, then after a 2 week washout, the alternative for 8 weeks. Plasma (weekly) and endocervical swabs (thrice weekly) were collected for HIV-1 RNA PCR. HIV-1 plasma levels were significantly lower during the valacyclovir arm compared with the placebo arm (−0.27 log10 copies/ml, p<0.001, a 46% decrease), as were cervical HIV-1 levels (−0.35 log10 copies/swab, p<0.001, a 55% decrease). Suppressive HSV-2 therapy could reduce HIV-1 infectiousness and slow HIV-1 disease progression. (ClinicalTrials.gov number ).