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Author Topic: Aciclovir reduces disease progression and death in people with HIV by nearly 20%  (Read 3627 times)

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Offline Luke

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HIV positive people given 400mg of aciclovir twice-daily as part of a trial to see if the drug reduced HIV transmission in serodiscordant couples were 17% less likely to progress to AIDS, to have to start antiretroviral therapy, or die, the Fifth IAS Conference was told on its final day.

http://www.aidsmap.com/en/news/4D56F855-6B95-4D42-B984-C66CED4079A6.asp

Not sure how comfortable I am with the idea of using aciclovir to delay starting treatment - or the apparent, but unproven, assumption that it is actually the suppression of HSV that is delaying progression to AIDS - but interesting none the less I thought.

Edited to add:

Reason for doubting that it is the suppression of HSV that is delaying progression to AIDS: http://www.nih.gov/news/health/sep2008/nichd-10.htm and http://aidsmap.com/en/news/AE968E37-6F05-4F0F-8FB9-E3A7C39CA15F.asp
« Last Edit: July 23, 2009, 05:13:46 PM by Luke »

Offline Inchlingblue

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When I was first diagnosed my numbers were decent so my doctor recommended I take daily Valtrex since it has been known for some time that active herpes infection stimulates HIV replication. I did take it for several months and I had a drop in my HIV viral load (from about 24k to 7k). Hard to say if it was just due to the Valtrex but it could have been.

I then read that taking daily Valtrex (or acyclovir, same thing) can cause a mutation in HIV (V75i) although, according to Dr. Gallant, this mutation "could have modest affects on susceptibility to ddI and d4T--drugs we don't use much anymore." It is possible, though, to develop resistance to acyclovir for treating herpes, which I guess one has to watch out for. I basically decided to stop using it daily and after I stopped my viral load remained about the same (7k).

I believe Ann has been on long term acyclovir for herpes suppression. Aidsmap has reported this before and there have been several threads about it.

LINKS TO A FEW OTHER THREADS ON THIS SUBJECT:

http://forums.poz.com/index.php?topic=10290.0

http://forums.poz.com/index.php?topic=26190.0

http://forums.poz.com/index.php?topic=26069.0
« Last Edit: July 23, 2009, 05:27:17 PM by Inchlingblue »

Offline Luke

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The active herpes stimulating HIV replication is kind of old science. Since it was found that aciclovir has exactly the same antiretroviral effect in people who are not infected with HSV, the HSV effect is now thought to be more to do with shedding than actual rate of replication.

Thanks for the links, but they are kind of tangential. It is the discussion surrounding these new papers that is interesting .. and none of them cover that.  
« Last Edit: July 23, 2009, 06:19:23 PM by Luke »

Offline Inchlingblue

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The findings you are talking about (if you are referring to the second link in your original post, dated September 2008, not exactly "new") are the reason acyclovir has an effect on HIV that results in the V75i mutation, which is why I mentioned that mutation (so not exactly "tangential," rather, to the point).

The first link, from aidsmap, doesn't say anything about the participants not having herpes, quite the opposite, it poses the question, "Could HSV-2 suppression slow HIV disease progression in HIV-infected persons not eligible for ART by current national guidelines, Dr Lingappa asked?"  Again, this is something that has already been observed and reported on.
« Last Edit: July 23, 2009, 07:59:41 PM by Inchlingblue »

Offline Luke

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Erm .. I haven't said that the second link is new and I haven't disputed the mutation information (because I agree with it .. although it probably isn't an issue for those of us who are on long-term preventative treatments, because it is frequent starting and stopping which causes mutation problems) and I didn't say anything about any of the study patients not having HSV.
« Last Edit: July 23, 2009, 07:31:29 PM by Luke »

Offline Inchlingblue

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Erm .. I haven't disputed the mutation information (because I agree with it .. although it probably isn't an issue for those of us who are on long-term preventative treatments, because it is frequent starting and stopping which causes mutation problems) and I didn't say anything about any of the study patients not having HSV.

You had said that "it was found that aciclovir (sic) has exactly the same antiretroviral effect in people who are not infected with HSV," but where are you getting this information? I guess that's what's confusing me. All the studies on acyclovir  and HIV that I have come across, including the ones that you cite above, have been done on people co-infected with HSV and HIV.
 

Offline Luke

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Quote
You had said that "it was found that aciclovir (sic) has exactly the same antiretroviral effect in people who are not infected with HSV,"

Yes I did .. but I didn't say it was from that study.

Quote
aciclovir (sic)

Yes, aciclovir, because that is the correct international nonproprietary name (INN) for the drug.


Offline Inchlingblue

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Bottom line: In the absence of HSV acyclovir has not been shown to have any effect on HIV. It's effect on HIV is when it is in its  phosphorylated form, which happens after it has been taken up by a cell infected with herpes viruses.

I'm just not sure where you got the information that acyclovir has exactly the same antiretroviral effect in people who are not infected with HSV. I'm not trying to give you a hard time, nor am I doubting you for the sake of doubting you, I'm genuinely curious about these things and would love to see a source if you have one.

SOURCE FOR WHAT I STATED ABOVE (YOUR SECOND LINK IN ORIGINAL POST):

http://www.nih.gov/news/health/sep2008/nichd-10.htm

« Last Edit: July 23, 2009, 07:46:07 PM by Inchlingblue »

Offline Luke

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I do admire your capacity for turning your opinions into fact - even when you don't have the facts to back it up.

With that I will leave you to it; because this, just like all the other threads you add your spurious facts to,  is turning into such a nonsensical tangent that it just isn't even worth pursuing.

Offline Inchlingblue

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I do admire your capacity for turning your opinions into fact - even when you don't have the facts to back it up.

With that I will leave you to it, because this is such a nonsensical tangent that it just isn't even worth pursuing.

Luke, if you have a source for saying that acyclovir "has exactly the same antiretroviral effect in people who are not infected with HSV" that would be great. If you don't then you should admit you were mistaken, there is nothing wrong in that.  You keep saying this is "tangential" but you are the one who brought it all up! I'm only commenting on what you said. ;)

Everything I've said re: acyclovir and HIV in this thread I have backed up with links.
« Last Edit: July 23, 2009, 08:12:58 PM by Inchlingblue »

Offline Luke

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There is nothing to admit - but if you really wanted the sources for that one statement you should just have asked for them rather than repeatedly making out that I have made all sorts of other statements that I haven't made - and make banal attempts to belittle the correct spelling of aciclovir - simply because you are pissed about some other thread.

Offline Inchlingblue

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There is nothing to admit - but if you really wanted the sources for that one statement you should just have asked for them rather than repeatedly making out that I have made all sorts of other statements that I haven't made - and make banal attempts to belittle the correct spelling of aciclovir - simply because you are pissed about some other thread.

I'm sorry about attempting to correct you on the spelling of acyclovir/aciclovir. My bad.

For the record, I have asked for the source, several times (just read my posts). I'm not at all pissed about any other thread. I genuinely like you, this is not at all personal. I happen to be an HIV Research Geek so if someone makes a comment such as the one you made, I am (as mentioned above) curious and interested in reading up on it.
« Last Edit: July 23, 2009, 08:09:07 PM by Inchlingblue »

Offline Luke

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I'm sorry about attempting to correct you on the spelling of acyclovir/aciclovir. My bad.

For the record, I have asked for the source, several times (just read my posts). I'm not at all pissed about any other thread. I genuinely like you, this is not at all personal. I happen to be an HIV Research Geek so if someone makes a comment such as the one you made, I am (as mentioned above) curious and interested in reading up on it.

How impressively disingenuous of you, Inchlingblue.

As for you being curious and wanting to read up, I have already provided the link and you have already read it (supposedly) and cited it; but you are either misunderstanding or wilfully misrepresenting it (and I am sorry, but when you continually try to misrepresent what I have said, I really don't have any reason to assume any good faith on your part).

When you say:

You had said that "it was found that aciclovir (sic) has exactly the same antiretroviral effect in people who are not infected with HSV", but where are you getting this information? I guess that's what's confusing me. All the studies on acyclovir and HIV that I have come across, including the ones that you cite above, have been done on people co-infected with HSV and HIV.

and

Bottom line: In the absence of HSV acyclovir has not been shown to have any effect on HIV.

... and then use then the NIH link (which I provided) to back the statements up, it is you who is wrong.

For one: you are trying to create a straw man in order to manufacture an argument against something I haven't ever said.

For two: Lisco doesn't say what you paraphrase it as saying in your "bottom line". The whole big point about the findings of the Lisco study (Acyclovir is activated into HIV-1 reverse transcriptase inhibitor in herpesvirus-infected human tissues), as reported by the NIH, is the conclusion that the presence of almost any of the human herpesviridae - not just HSV - activates the phosphorylated form. Almost everyone is infected with a herpesviridae (HHV-6 alone, which isn't an HSV, infects 93% of all adults), but most people aren't infected with HSV.

Better still, by using valacyclovir (the pro-drug version of aciclovir) and altering the way it is processed, they can even bypass the need for the phosphorylation of aciclovir by a herpes viruses.

Once more, from the NIH link on which you claim to have based your statements:

Quote
The most well known herpes viruses, herpes simplex virus-1 and herpes simplex virus-2, cause cold sores and genital herpes, respectively. Several other herpes viruses, however, are believed to be benign and donít cause any symptoms in adults, explained the studyís senior author, Leonid Margolis, M.D., Ph.D., head of NICHDís Section on Intercellular Interactions. These benign viruses are so widespread that most people probably harbor one type or another and donít realize it.

My statement that "aciclovir has exactly the same antiretroviral effect in people who are not infected with HSV", which is what you were pulling me up on, still stands and was always backed up, in the very first post, by http://www.nih.gov/news/health/sep2008/nichd-10.htm

Everything I've said re: acyclovir and HIV in this thread I have backed up with links.

Bottom line: In the absence of HSV acyclovir has not been shown to have any effect on HIV.

*coughs*

If you don't then you should admit you were mistaken, there is nothing wrong in that.

.....

Feel free to admit your 'misunderstanding', but I really am done now, because all this really is very tangential, tiresome as hell and just about you wanting some sort of revenge.

Edited for typo
« Last Edit: July 24, 2009, 01:34:05 PM by Luke »

Offline georgep77

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Take a deep breath luke, and get your anger out

                                 ;)
Come on Sangamo,  Geovax,  Bionor immuno, ...Make us happy !!!
+ 2008

Offline Inchlingblue

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Take a deep breath luke, and get your anger out

                                 ;)

You took the words right out of my mouth (keyboard). ;)

Offline Robert

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luke.

I know you could care less but you really do come out looking like as ass in this thread.  And I would imagine if anyone here ever has any questions pertaining to aciclovir and HIV you'll be the last person they'll ask.

robt
..........

Offline Luke

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You are quite right, Robert: I really don't give a flying f*** what you, of all people, actually think.

As I have said before: it is a funny old habit of mine, but I generally need people to have an intellect that is marginally above that of a frozen pig shit on a stick, before I start to pay any particular attention to anything they have to say.
« Last Edit: July 25, 2009, 03:30:27 AM by Luke »

Offline Ann

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You are quite right, Robert: I really don't give a flying f*** what you, of all people, actually think.

As I have said before: it is a funny old habit of mine, but I generally need people to have an intellect that is marginally above that of a frozen pig shit on a stick, before I start to pay any particular attention to anything they have to say.


Well Luke, maybe you should give a flying f*** what people on this forum think. You've pushed the limits several times in the short time you've been a member here. This is the third time you've been warned - and yes, this is a warning. Once again you're letting the personal insults fly instead of sticking to the issues.

For someone who thinks so highly of their own intellect, it would seem you should be capable of getting your point across without constantly resorting to name-calling and other personal attacks.

If I have to warn you one more time in the upcoming weeks, you'll be given a time out. Enough is enough already. Either abide by our forum posting guidelines and stop with the personal attacks, or find yourself timed out for a cooling off period.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Luke

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Ann

Just go and swivel on it and give me a time-out then. I'll respect your opinion when you hold yourself and the people who, in each and every instance, have attacked me first to the same standards. Until then, quite frankly, I'll just be laughing at your transparent attempts to protect your own little clique.  

Offline edfu

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Luke, your hauteur and arrogance are juvenile, unnecessary, and grossly impolite.   Who appointed you the supreme arbiter of intelligence?  Please go away and play with the other children. 
"No one will ever be free so long as there are pestilences."--Albert Camus, "The Plague"

"Mankind can never be free until the last brick in the last church falls on the head of the last priest."--Voltaire

Offline Luke

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Offline Ann

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Ann

Just go and swivel on it and give me a time-out then. I'll respect your opinion when you hold yourself and the people who, in each and every instance, have attacked me first to the same standards. Until then, quite frankly, I'll just be laughing at your transparent attempts to protect your own little clique.  


Luke,

I could have gone straight to a time out - but I wanted to give you a chance to stop with the personal attacks and tit-for-tat you're so fond of engaging in. But no, you saw fit to also attack me personally. I really didn't want to give you a time out as many of your contributions are valuable. However, we cannot allow you to attack anyone who disagrees with you or wants to bring up a different point of view.

And if you want to laugh at an imaginary clique, go right ahead.

As this is your first time out, it will last seven days. Creating a new account to get around your time out will result in a permanent ban.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Ann

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Luke, your hauteur and arrogance are juvenile, unnecessary, and grossly impolite.   Who appointed you the supreme arbiter of intelligence?  Please go away and play with the other children. 


Ed, it's really not appreciated when other members chime in in a situation like this when a moderator has already issued a warning. Please don't do it again. Thank you for your cooperation.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

 


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