Valacyclovir, a drug generally used to treat the virus that leads to genital herpes, seems to decrease the levels of HIV in sufferers who do not have genital herpes, with respect to a research by investigators from the National Institutes of Health and from different Universities.
The research of 18 sufferers is the initial to show that the drug does not need the presence of herpes simplex virus 2 (HSV-2) to reduce HIV in sufferers. The investigators desire to confirm their outcomes in a larger study.
Senior author Leonid Margolis stated “These results are very motivating, If valacyclovir’s effectiveness towards HIV can be proved in a larger cohort, it could be included to the combination of drugs used to reduce the virus, and might confirm particularly helpful in cases in which HIV has developed resistance to other HIV drugs.”
The research, presented online recently in Clinical Infectious Diseases, was backed by NIH’s Bench to Bedside Program, which finances research teams aiming to translate basic scientific results into medical practice. The initial authors of this paper are Christophe Vanpouille and Andrea Lisco, both with National Institute of Child Health and Human Development (NICHD). Other authors are Michael Lederman (senior author), Benigno Rodriguez, Leda Bassit, Robert Kauffman,Raymond F. Schinazi (senior author) and Jorge Sanchez.
These outcomes follow a 2008 research by the same research team, which revealed that acyclovir suppresses HIV in laboratory cultures of human tissues that were infected with different types of herpes viruses. Valacyclovir is known to as a prodrug for acyclovir because it’s structurally identical to acyclovir, and is converted to acyclovir in the human body. For the present study, the investigators used valacyclovir because it stays in the blood more time than acyclovir and so would not need to be taken as usually.
Previous research have proven that acyclovir decreases HIV levels in sufferers coinfected with HIV and HSV-2, the virus that leads to genital herpes. However, this impact has been attributed to the drug’s anti-HSV-2 activity. The decrease in immune activity outcomes in fewer active immune cells for HIV to infect.
In comparison, the laboratory outcomes of the research team suggested that the drug probably decreased HIV levels by interfering immediately with HIV’s reproductive machinery and did not need the existence of HSV-2. HSV-2 chemically modifies acyclovir, by linking chemical groups called phosphates to it. It is this modified type of the drug that suppresses HSV-2. The scientists consider this form also interferes with HIV’s capability to reproduce. In their previous study, the scientists identified that many other types of herpes viruses can also attach phosphate groups to acyclovir. Dr. Margolis mentioned that these other herpes viruses are extensive and that most individuals harbor at least one of them.
Dr. Margolis stated “We desired to figure out whether such a mechanism could function in the cells of individuals with HIV”.
The scientists registered 18 HIV-infected sufferers in their research, none of whom were infected with HSV-2, and treated them with valacyclovir. For 12 weeks, half of the registered sufferers took valacyclovir twice a day while the other half obtained a placebo. Following two weeks, the placebo group obtained valacyclovir while the group initially treated with the drug switched to the placebo.
The investigators identified that when the sufferers took valacyclovir, their blood HIV levels dropped considerably. Generally, HIV sufferers take a cocktail of External Web Site Policy several anti-HIV medication because a single medication is not sufficient to reduce the virus. Multiple HIV drugs also hinder the virus’ capability to develop resistance to the medicines.
The scientists carried out a genetic analysis and identified that the HIV in the research volunteers did not develop resistance to valacyclovir. But because HIV has a history of getting resistant to the medicines used to treat it, the scientists do not discount the probability that the virus could develop level of resistance to valacyclovir with longer therapy. Given the capability of the drug to reduced HIV levels, however, the investigators think that valacyclovir could one day be added to the cocktail of medicines given to HIV-infected individuals.
“Larger randomized studies and cost effectiveness analyses could be warranted to additional explore the possible of [valacyclovir] in the context of HIV-1 infection, in specific in combination with other antivirals,” the research authors wrote.