Usage of Acyclovir for Suppression of HIV-1 and HSV-2 Coinfected Persons in Cameroon

The main objective is to assess the reduction in genital HIV-1 shedding associated with daily acyclovir for suppression of HSV-2 reactivation.

All patients will be treated with the usual antibiotic treatment for any sexually transmitted infections that are diagnosed during the study. In addition, half will receive acyclovir for 8 weeks , whilst the other half will receive a placebo for 8 weeks. The study medication will reverse in the second 8 weeks of the study. The patients will attend the clinic 3 times per week during the first and the last 8 weeks of the study and once every week during the washout period in the middle of the study - for a total of 18 weeks per participant. At each visit genital and oral samples will be collected. A blood sample will also be collected. For women participants, pregnancy test will be performed. The clinic will provide both pre- and post-HIV test counseling.

Inclusion criteria

• 18 years old and above
• Documented HIV-seropositive
• HSV-2 seropositive as determined by Focus EIA
• Not intending to move out of the area for the duration of study participation
• Willing and able to:

• provide independent written informed consent
• undergo clinical evaluations
• take study drug as directed
• adhere to follow-up schedule
• Bacterial STDs (symptomatic STD syndromes or laboratory-confirmed asymptomatic gonorrhea, chlamydia, syphilis) are treated within two weeks if study enrollment and random assignment.

Exclusion criteria

• Women who meet any of the following criteria are not eligible for this study.

• Known history of adverse reaction to acyclovir
• Planned open label use of acyclovir, valacyclovir, or famciclovir
• Positive pregnancy test
• Active opportunistic infection