Decreased monocyte activation with daily acyclovir use in HIV-1/HSV-2 coinfected women

作者：Redd Andrew D; Newell Kevin; Patel Eshan U; Nalugoda Fred; Ssebbowa Paschal; Kalibbala Sarah; Frank Melanie A; Tobian Aaron A R; Gray Ronald H; Quinn Thomas C; Serwadda David; Reynolds Steven J^*

来源：Sexually Transmitted Infections, 2015, 91(7): 485-488.

DOI：10.1136/sextrans-2014-051867

Objectives Several clinical trials have demonstrated that daily treatment of HIV-infected individuals with the antiherpes drug acyclovir slightly decreases HIV-1 viral load and slows disease progression. This study examines if this slowing in clinical progression is a direct cause of the decrease in viral load or an indirect effect of lower immune activation due to lower levels of herpetic reactivation.
Methods Women who participated in a randomised clinical trial of daily acyclovir use (n=301) were monitored every 6 months for changes in immune activation. Soluble CD14 (sCD14), a marker for monocyte activation, and C-reactive protein (CRP), a marker for general immune activation, were measured by ELISA.
Results Initial levels of sCD14 and CRP were not predictive of HIV disease progression when controlling for initial CD4+ cell count and HIV viral load. sCD14 levels, but not CRP, decreased in the acyclovir treatment arm at a significantly faster rate than the placebo group, which was independent of changes in HIV viral load and CD4+ cell count in a multivariant mixed-effects model (p=0.039). However, the magnitude of this decrease was relatively small with a total estimated decrease of sCD14 of 15% of initial levels.
Conclusions These data suggest that decreased monocyte activation may play a minor role in the ability of daily acyclovir use to slow HIV disease progression.

• 出版日期2015-11
• 单位NIH