Breaking the Connection Between HSV-2 and HIV

Infection with herpes simplex virus type 2 (HSV-2) is a known risk factor for HIV acquisition. To test whether antiviral therapy to suppress HSV-2 would reduce risk for HIV acquisition, investigators enrolled 821 women (age range, 16–35) who were HIV seronegative and HSV-2 seropositive, who worked at recreational facilities in Tanzania, and who were at moderately high risk for HIV acquisition. Participants were randomized to receive acyclovir (400 mg twice daily) or placebo and were followed for 12 to 30 months. Safer-sex counseling, condoms, and syndromic management of sexually transmitted infections were provided.

Overall, 83% of the women completed follow-up. Median adherence to therapy (based on pill count) was 90%. Acyclovir had no obse…