PMID- 19726982
OWN - NLM
STAT- MEDLINE
DCOM- 20100105
LR  - 20150813
IS  - 1473-6527 (Electronic)
IS  - 0951-7375 (Linking)
VI  - 22
IP  - 6
DP  - 2009 Dec
TI  - Acyclovir: a new use for an old drug.
PG  - 583-7
LID - 10.1097/QCO.0b013e32833229b8 [doi]
AB  - PURPOSE OF REVIEW: Epidemiological studies have demonstrated that HIV-1 and 
      herpes simplex virus-2 (HSV-2) are responsible for two epidemics and that, by 
      overlapping in risk populations, they reinforce the spreading of both HIV-1 
      disease and genital herpes. Randomized controlled trials have investigated 
      whether acyclovir (ACV), a synthetic drug designed to suppress herpes viruses, 
      might provide an inexpensive and safe way to drastically reduce HIV-1 spreading 
      around the world. The controversial results of these trials are reviewed below in 
      light of the recent discovery of the direct suppression of HIV-1 by ACV. RECENT 
      FINDINGS: Recent studies have shown that although ACV therapy does not prevent 
      HIV-1 transmission, it decreases plasma, genital, rectal, and seminal HIV-1 RNA 
      levels. The decrease of HIV-1 load has been believed to be the result of an 
      indirect mechanism and explained by reduction of HSV-2-mediated inflammation. The 
      discovery of the direct inhibitory activity of ACV on HIV-1 reverse transcriptase 
      brings new insights into the interpretation of these results. Also, it is 
      important to understand why HSV-2-suppressive therapy with ACV did not reduce 
      HIV-1 acquisition/transmission. SUMMARY: The direct suppression of HIV-1 by ACV 
      activated by coinfecting HSV-2 may in part explain the ACV-induced decrease of 
      HIV load reported in several clinical trials. If this is the case, other herpes 
      viruses capable of ACV activation may contribute to this effect. New basic 
      studies and new targeted clinical trials are needed to understand whether ACV 
      therapy can also be beneficial for HSV-2-negative patients. These studies will 
      show whether ACV therapy should be included in HIV-1 treatment as well as whether 
      ACV-based drugs specifically targeting HIV-1 can be developed.
FAU - Vanpouille, Christophe
AU  - Vanpouille C
AD  - Eunice Kennedy Shriver National Institute of Child Health and Human Development, 
      National Institutes of Health, Bethesda, MD 20892, USA.
FAU - Lisco, Andrea
AU  - Lisco A
FAU - Margolis, Leonid
AU  - Margolis L
LA  - eng
GR  - Intramural NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, N.I.H., Intramural
PT  - Review
PL  - United States
TA  - Curr Opin Infect Dis
JT  - Current opinion in infectious diseases
JID - 8809878
RN  - 0 (Antiviral Agents)
RN  - EC 2.7.7.- (reverse transcriptase, Human immunodeficiency virus 1)
RN  - EC 2.7.7.49 (HIV Reverse Transcriptase)
RN  - X4HES1O11F (Acyclovir)
SB  - IM
MH  - Acyclovir/*therapeutic use
MH  - Antiviral Agents/*therapeutic use
MH  - HIV Infections/*drug therapy/transmission
MH  - HIV Reverse Transcriptase/drug effects
MH  - HIV-1/*drug effects/physiology
MH  - Herpes Simplex/drug therapy
MH  - Humans
MH  - Randomized Controlled Trials as Topic
MH  - Viral Load/drug effects
RF  - 40
EDAT- 2009/09/04 06:00
MHDA- 2010/01/06 06:00
CRDT- 2009/09/04 06:00
PHST- 2009/09/04 06:00 [entrez]
PHST- 2009/09/04 06:00 [pubmed]
PHST- 2010/01/06 06:00 [medline]
AID - 10.1097/QCO.0b013e32833229b8 [doi]
PST - ppublish
SO  - Curr Opin Infect Dis. 2009 Dec;22(6):583-7. doi: 10.1097/QCO.0b013e32833229b8.