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DDW 2013: Does Treating Herpes Help Suppress Hepatitis C Virus?

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Treating herpes simplex virus type 2 (HSV-2) with valacyclovir (Valtrex) was associated with a substantial reduction in plasma hepatitis C virus levels in dually-infected individuals, according to a small study presented at the Digestive Disease Week conference (DDW 2013)this week in Orlando.

 

Mary Jane Burton from the G.V. Sonny Montgomery VA Medical Center in Jackson, Mississippi, and colleagues performed a pilot study to evaluate the safety and impact of valacyclovir on HCV levels in veterans with HSV-2 and HCV coinfection.

This exploratory study was motivated by previous research showing that suppressing HSV-2 with valacyclovir is associated with decreased HIV viral load in HSV-2/HIV coinfected individuals, the researchers noted as background. This may be related to reduced immune activation and inflammation when one chronic viral infection is brought under control.

This analysis included 30 veterans infected with both HSV-2 and genotype 1 HCV. People with HIV and hepatitis B were excluded. All but 2 were men and two-thirds were African-America.

Participants were randomly assigned to receive either 1 g twice-daily valacyclovir or placebo for 8 weeks. After a 2-week wash-out period, they switched over to the alternate assignment for an additional 8 weeks.

Results

  • Mean HCV RNA levels fell by 24% (or 1.3 million IU/mL) during acyclovir treatment, significantly more than during the placebo phase.
  • However, no "carryover effect" was observed after valacyclovir was discontinued.
  • Alanine aminotransferase (ALT) levels -- and indicator of liver inflammation -- decreased by 6% to 10% during the valacyclovir phase.
  • Valacyclovir was safe and well-tolerated, with no serious adverse events or laboratory abnormalites.
  • Headache was reported more often during the valacyclovir phase.

Based on these findings, the researchers recommended, "Larger studies should be performed to assess the potential impact of HSV-2 suppression on HCV viral load and liver disease progression in this difficult to treat population."

5/22/13

Reference

MJ Burton, AD Penman, I Sunesara, et al. The Effect of Herpes Simplex Type-2 (Hsv-2) Suppression on Hepatitis C (HCV) Viral Load in Veterans With HSV-2/HCV Co-Infection. Digestive Disease Week. Orlando, May 18-21, 2013. Abstract Sa1032.