Reprinted from Project Inform Newsletter.

[Guest guest]

Coverage of CROI 2009 (Conference on Retroviruses and Opportunistic Infections)

February 8–11, 2009, Montreal, Canada

Acyclovir: the next new HIV drug?

by Alan McCord, February 10, 2009

In two poster presentations at CROI 2009 in Montreal, Canada, acyclovir, a drug used to treat herpes, shows that it also inhibits HIV during the reverse transcription (RT) step in the virus’s life cycle. Two studies looked at how acyclovir affected the RT enzyme, which may pave the way to using the drug to treat HIV infection either on its own or together with herpes therapy.

In the first study, in an attempt to find compounds with novel anti-HIV activity, a team from Hopkins School of Medicine and Medical Institute searched through nearly 3000 FDA-approved drugs or other drugs in phase II studies. Twenty were found to have moderate activity against HIV and 18 were selected for this study.

In the lab, CD4 cells were infected with HIV and then exposed to 10 mM of acyclovir. Cultures were also individually exposed to the other 17 compounds. Viral load tests were done to assess the reduction of HIV levels. Other tests were used to confirm whether the RT enzyme was the drug’s target. Herpes infection and activity were also examined. Acyclovir, along with the other compounds, was shown to suppress HIV replication.

The second study looked at the activity of acyclovir on HIV in various tissues from the tonsils, lymph nodes, rectum and genital tract, all co-infected with various human herpes viruses. After treating HIV-infected cells with acyclovir, viral loads and RT activity were assessed.

If the cells had both HIV and herpes viruses in them, then acyclovir suppressed HIV reproduction in those cells. Conversely, if the cells didn’t have herpes virus in them, then acyclovir didn’t suppress HIV. However, when cells infected with herpes virus only were added to treated co-infected cell cultures, then acyclovir suppressed HIV again. This suppression of HIV appears to affect HIV that uses both R5 and X4 co-receptors.

More study is needed to discover how acyclovir interacts with HIV, both with and without the presence of a herpes infection. One main concern here is how acyclovir may affect HIV mutations. For example, when people with HIV are simply treating their herpes and not their HIV, they may actually be on “HIV monotherapy†which may then lead to poorer HIV therapy outcomes. This data comes in light of reported studies from CROI 2008 that showed using acyclovir in herpes-infected individuals increased the risk of HIV infection.

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[Guest guest]

I am convinced of Acyclovir ( or Famvir) HIV control effects. My viral load went down by a log when I started it daily.  Some researchers think that it does not have a direct effect on HIV, but that controlling herpes virus viral load can also decrease immune activation and , thus, decrease HIV replication. Others think that it can increase the intracellular levels of nucleoside analogs and that is what is doing the job

Re: Reprinted from Project Inform Newsletter.

I was quite surprised to see the information about Acyclovir.  In 1990 (!!) I participated in a VERY large placebo-controlled treatment trial for AZT with and without Acyclovir.  When the study was unblinded it turned out that I was on the Acyclovir arm.  The treatment trial conclusions were that Acyclovir did not make a difference.  I don't remember specifically what the conclusions were, but they were essentially negative.

 

The results reported in the news release below are certainly interesting, especially the possible consequence of someone who is poz and who has herpes, an

d who is using Acyclovir but not (yet) on ARV treatment.

 

Jerry

 

In a message dated 3/15/2009 3:24:20 P.M. Eastern Daylight Time, lsmyle@... writes:

Coverage of CROI 2009 (Conference on Retroviruses and Opportunistic Infections)

February 8–11, 2009, Montreal, Canada

Acyc

lovir: the next new HIV drug?

by Alan McCord, February 10, 2009

In two poster presentations at CROI 2009 in Montreal, Canada, acyclovir, a drug used to treat herpes, shows that it also inhibits HIV during the reverse transcription (RT) step in the virus’s life cycle. Two studies looked at how acyclovir affected the RT enzyme, which may pave the way to using the drug to treat HIV infection either on its own or together with herpes therapy.

In the first study, in an attempt to find compounds with novel anti-HIV activity, a team from Hopkins School of Medicine and Medical Institute searched through nearly 3000 FDA-approved drugs or other drugs in phase II studies. Twenty were found to have moderate activity against HIV and 18 were selected for this study.

In the lab, CD4 cells were infected with HIV and then exposed to 10 mM of acyclovir. Cultures were also individually exposed to the other 17 compounds. Viral load tests were done to assess the reduction of HIV levels. Other tests were used to confirm whether the RT =2

0 enzyme was the drug’s target. Herpes infection and activity were also examined. Acyclovir, along with the other compounds, was shown to suppress HIV replication.

The second study looked at the activity of acyclovir on HIV in various tissues from the tonsils, lymph nodes, rectum and genital tract, all co-infected with various human herpes viruses. After treating HIV-infected cells with acyclovir, viral loads and RT activity were assessed.

If the cells had both HIV and herpes viruses in them, then acyclovir suppressed HIV reproduction in those cells. Conversely, if the cells didn’t have herpes virus in them, then acyclovir didn’t suppress HIV. However, when cells infected with herpes virus only were added to treated co-infected cell cultures, then acyclovir suppressed HIV again. This suppression of HIV appears to affect HIV that uses both R5 and X4 co-receptors..

More study is needed to discover how acyclovir interacts with HIV, both with and without the presence of a herpes infection. One main concern here is how acyclovir may affect HIV mutations. For exam

ple, when people with HIV are simply treating their herpes and not their HIV, they may actually be on “HIV monotherapy†which may then lead to poorer HIV therapy outcomes. This data comes in light of reported studies from CROI 2008 that showed using acyclovir in herpes-infected individuals increased the risk of HIV infection.

 

 

CONFERENCE

COVERAGE

2009 CROI

2008 ICAAC / IDSA

2008 Int'l Conference

2008 CROI

2007 ICAAC

2007 IAS

2007 CROI

2006 Int'l Conference

 

 

2008   2007

 

 

 

 

 

© 2009 Project Inform  1375 Mission Street,  San Francisco, CA 94103  415-558-8669

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