Acyclovir Use and Survival Among Human Immunodeficiency Virus‐Infected Patients with CD4 Cell Counts of < 500/mm

Abstract

To examine the relationship between acyclovir use and survival in AIDS, we performed a retrospective analysis of data collected through an observational cohort of the 17-site Community Program for Clinical Research on AIDS (CPCRA), under the sponsorship of the National Institute of Allergy and Infectious Diseases. Data were analyzed regarding 2,368 patients with CD4+ lymphocyte counts of < 500/mm3, and 7,836 follow-up visits were conducted from September 1990 to July 1994. Factors associated with use of acyclovir were studied by stratified analysis of variance and Mantel-Haenzel chi 2 tests. The association between acyclovir and survival was studied with use of the proportional hazards regression model. Individuals reporting acyclovir use were more likely to be white, male, and homosexual; to have a history of herpes simplex and zoster; and to have lower CD4+ T cell counts than those who did not. After adjustments for differences in baseline factors, acyclovir use was not associated with prolonged survival.

No Protective Effect of Acyclovir on HIV Disease Progression in a Cohort of Hsv-2–HIV-Infected Individuals

“…These findings have led to HSV treatment being incorporated in the treatment of HIV infection with the scope of reducing both HSV replication and its activating effect on HIV, and obtaining, as a consequence, a benefit in survival. However, results from different studies have been discordant [8,9], although all of these studies were conducted among prevalent cohorts (that is, with unknown date of seroconversion) and were thus not able to measure changes in the duration of the AIDS-free period but only changes in survival between AIDS diagnosis and death, with short follow-up periods. Moreover, they did not adjust for antiretroviral therapy, which can be administered simultaneously with acyclovir and may represent the true reason for a benefit in survival.…”