HSV-Suppressive Therapy Might Improve HIV Status in Dually Infected Women

The worldwide epidemics of HIV and herpes simplex virus 2 infection intersect: Most HIV-positive persons also have HSV-2 infection, and HSV-2 reactivation appears to increase both systemic and genital HIV RNA. To determine whether HSV-suppressive therapy reduces HIV-1 replication in dually infected women, investigators in Africa examined the efficacy of valacyclovir in women who were seropositive for HIV and HSV-2 and who were not eligible for antiretroviral therapy. During a 12-week baseline phase, genital and plasma HIV-1 RNA and genital HSV-2 DNA were measured every 2 weeks. At the end of this period, 140 eligible women were randomized to receive valacyclovir (500 mg twice daily) or placebo for another 12 weeks, during which time genital…