Reduction of HIV-1 RNA Levels with Therapy to Suppress Herpes Simplex Virus

Coinfection with herpes simplex virus type 2 (HSV-2) in women with HIV-1 infection is associated with increased genital shedding of HIV-1 RNA. In this randomized, double-blind, placebo-controlled trial, suppression of HSV-2 with valacyclovir decreased genital HIV-1 RNA and mean plasma HIV-1 RNA levels in dually infected women in Burkina Faso. Suppression of HSV-2 with valacyclovir decreased genital HIV-1 RNA and mean plasma HIV-1 RNA levels in dually infected women in Burkina Faso. Epidemiologic and biologic data support a strong association between herpes simplex virus type 2 (HSV-2) and infection with human immunodeficiency virus type 1 (HIV-1). 1 – 5 A recent meta-analysis of prospective observational studies showed that patients who were seropositive for HSV-2 had three times the risk of acquiring HIV-1, as compared with those who were seronegative for the virus. 6 In addition, three of four studies showed that HSV-2 infection may increase the quantity of genital HIV-1 RNA. 7 – 10 This association probably arises from both symptomatic 11 and asymptomatic genital shedding of HSV-2 DNA, although the evidence for the latter is weaker. 12 The . . .