Active herpes boosts HIV levels

USA Today (Society for the Advancement of Education), Feb, 1996

Active infection with herpes simplex drastically increases the amount of HIV in the bloodstream of people carrying the Aids-causing virus, a Stanford University School of Medicine study found. Many scientists have suspected some sort of connection between HIV and herpes infection, but they have had difficulty verifying it and defining just how the two might interact. "Clinically, the study helps validate what we have suspected. The relationship between herpes and HIV is clearly a real phenomenon," explains Mark Holodniy, director of the AIDS Research Center at the Stanford-affiliated Veterans Affairs Medical Center, Palo Alto, Calif.

Most HIV-positive patients harbor latent herpes, a chronic condition in which the virus hibernates in nerve cells after initially causing a flu-like illness and painful skin ulcerations on the mouth, genitals, or other mucous membranes. Stress and illness can reactivate the dormant virus, causing repeated eruptions of the lesions.

The finding may help explain why people with HIV disease live longer when treated with the anti-herpes drug acyclovir in addition to AZT (zidovudine) or other anti-HIV drugs, Holodniy points out. Acyclovir does not have anti-HIV properties. Accordingly, physicians should offer acyclovir as a preventive treatment to HIV-positive patients who have a history of herpes, he suggests. "Prophylaxis against herpes [reactivation] for HIV patients may be almost as important as AZT or other anti-HIV therapy in slowing the progression of HIV disease."

Why active herpes infection should boost HIV levels remains a subject of intense study. Herpes infects nerve cells; HIV, while it affects many cells, does its damage to the immune system by infecting white blood cells. Some scientists speculate that an initial or reactivated herpes infection provokes normal, non-HIV-infected white blood cells to migrate to the site of the skin ulcerations. The white cells come to fight off the herpes, but in the process become infected with HIV.