|Is It Helpful To Be Tested For Possible Cofactors?
Oct 2, 2000
Hi Dr. Pavia! Thanks for all the informative content you have added to this site and for your previous answers to questions I have sent in. I have just finished reading the very interesting and informative book, "The Virus Within". This book details facts about HHV-6 and the possible role it plays with HIV and progression to AIDS. My question is this: DO YOU THINK IT SERVES ANY PURPOSE OR IS AT THE VERY LEAST GOOD TO KNOW IF AN HIV+ PERSON IS ALSO INFECTED WITH HHV-6A, HHV-6B OR HHV-8 (ALL OF WHICH HAVE BEEN PROPOSED TO BE COFACTORS IN THE PROGRESSION FROM HIV TO AIDS)? AND IF SO, ARE THERE ACTUALLY TESTS OUT THERE TO IDENTIFY INFECTION FOR ALL THREE OF THESE IN THE BODY AND ARE THERE TREATMENTS FOR THESE THREE VIRUSES AT THIS POINT?
Thanks in advance for your answer to my question!
| Response from Dr. Pavia
Good questions. The vast majority of adults are probably already infected with one of the subtypes of HHV-6. It is a very common cause of non specific febrile illnesses in childhood and of roseola. While I think the issue of viral cofactors is an important area of research, and it seems pretty clear that some viral infections can act as cofactors, I don't think the issue is settled based on any available data for HHV-6 A or B. Therefore, knowing your status wouldn't even give you any prognostic information at this point. There are no known or recommended treatments at this point. The virus is sensitive to acyclovir in the test tube, however. Over the years, before the advent of HAART, there have been bits of information that show that acyclovir may slow progression to AIDS, especially among persons with frequent Herpes simplex activations. However, this is all from the no treatment or AZT monotherapy era.
HHV-8 is a different kettle of fish. As you know, it is quite common in gay men, but relatively rare in other groups. It is associated with KS and with some rare types of lymphoma. However, at this point, there is no clear benefit to treatment for HHV-8 if you are infected with both it and HIV. Some data suggest that ganciclovir or foscarnet may prevent KS, but these are expensive and toxic drugs if you don't need them for CMV. I can think of at least one reason to know your HHV-8 status, though. If you are negative, it is one more reason to be careful about safer sex, and if you are positive, it is another reason to protect your partners against the virus.
As usual, not all the answers are in. Hope this helps
Andrew T. Pavia, M.D.
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