Meta-analysis of randomized trials on the association of prophylactic acyclovir and HIV-1 viral load in individuals coinfected with herpes simplex virus-2

Christina Ludema, Stephen R. Cole, Charles Poole, Haitao Chu, Joseph J. Eron

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Objective: To summarize the randomized evidence regarding the association between acyclovir use and HIV-1 replication as measured by plasma HIV-1 RNA viral load among individuals coinfected with herpes simplex virus (HSV)-2. Design: Meta-analysis of seven randomized trials conducted between 2000 and 2009. Inclusion criteria composed of acyclovir or valacyclovir use as prophylaxis among individuals coinfected with HIV-1 and HSV-2 who were ineligible for highly active antiretroviral therapy. HIV-1 viral load was the outcome. Methods: Random-effects summarization was used to combine treatment effect estimates. Stratified and meta-regression analyses were used to compare estimated treatment effects by characteristics of trials and participants. Results: The summary treatment effect estimate was -0.33 (95% confidence interval: -0.56, -0.10, 95% population effects interval: -0.74, 0.08) log10 copies, an approximate halving of plasma viral load. However, there was marked heterogeneity (P < 0.001). Older median age, valacyclovir, higher compliance, earlier publication, and shorter study length were associated with a larger decrease in viral load as compared with their counterparts. Conclusion: Current evidence suggests a range of favorable effects of acyclovir on plasma HIV-1 viral load among persons coinfected with HSV-2.

Original languageEnglish (US)
Pages (from-to)1265-1269
Number of pages5
JournalAIDS
Volume25
Issue number10
DOIs
StatePublished - Jun 19 2011

Keywords

  • HIV
  • acyclovir
  • herpes simplex virus
  • meta-analysis

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