February 22, 2007
In a study of 140 Burkina Faso women with genital herpes, twice-daily valacyclovir 500-mg taken for three months was shown to reduce HIV in the blood and HIV shedding in the vagina, potentially lessening the risk of transmitting the virus.
The effect of valacyclovir increased steadily over time, so "a longer duration of treatment might have led to an even greater reduction" of HIV, suggested senior author Dr. Nicolas Nagot of the London School of Hygiene and Tropical Medicine and colleagues. Among people with HIV, up to 70 percent in Europe and 90 percent in Africa are co-infected with herpes simplex virus type 2 (HSV-2).
Dr. Phillip Keiser, who runs the AIDS clinic at the Dallas-based University of Texas Southwestern Medical Center, said the study would change the way he treats co-infected patients. "I'll be more aggressive in treating their herpes and keep them on the valacyclovir for a long time," said Keiser, who was not connected with the study. "This may be one of those small refinements that add something to that [success rate] and help our patients do better over the long haul."
The full study, "Reduction of HIV-1 RNA Levels with Therapy to Suppress Herpes Simplex Virus," was published in the New England Journal of Medicine (2007;356(8):790-799).