Acyclovir, Genital Herpes and HIV

Long-term treatment of genital herpes with the drug acyclovir does not reduce the incidence of new HIV infections. This unwelcome and surprising news was revealed during the International AIDS Conference in Mexico City, which concluded last Friday.

Dr. C. Celum of the University of Washington, Seattle, reported on results obtained from a multi-center trial which evaluated the effects of acyclovir. The trial included 1,814 gay men who have sex with men from Peru and the United States. Also included were 1,358 women from Zimbabwe, Zambia and South Africa who were infected with the herpes simplex virus type 2 (HSV-2), but not HIV.

During the trial one group received acyclovir and a second group received a placebo tablet. When the trial finished it was found that the incidence of genital ulcers was significantly lower in the group who took acyclovir, but the incidence of HIV infection was the same in both groups.

The findings have disappointed researchers because prior infection with HSV-2 had been reported to increase the risk of HIV many fold. The findings have forced a conclusion that long-term treatment of genital herpes with acyclovir will not reduce the rate of HIV infection.

Reports currently show that herpes rates are highest in women, gay men and black people. It is now estimated that genital HSV-2 infects at least 45 million Americans from age 12 upwards.  Whereas genital herpes had previously been considered a risk factor for HIV infection, these results mean that genital herpes is better thought of as a marker or facilitator of the spread of the HIV virus.

Not everyone is convinced that this is the end of the story. An alternative explanation put forward is that the interventions used against HSV were simply not potent enough for the desired effect.

More information about the International AIDS Conference can be found by visiting their website

Jerry Kennard is a psychologist & co-founder of www.embarrassments.co.uk