[Question #2440] hiv valtrex help

97 months ago

Hi, I was exposed to hiv dec10 2016, and I stated valtrex twice a day for 2 and a half months until end of February, That is 500 mg twice a day so 1000mg a day. My question is how long will that delay antibody/antigen. It is now known that valtrex has a direct impact on hiv. Even if you don't have herpes. I tested march 4 with the 4generation blood test. It was negative. Then I stopped valtrex in march for about 6 weeks and tested again on April 17. It was negative. And I tested may 5. It was negative. How long does valtrex stay in system.since exposure thrush and my cd4 dropped from (Jan 30,)1000 to feb1 (480). I did hiv rna may 11 not detected. But I took valtrex may 4to may 11 That would 14 pills. I have never had herpes 2 Since exposure my buttock have been burning crawling feeling.

H. Hunter Handsfield, MD

97 months ago

Welcome to the forum. Thanks for your question.

Early in the recognized HIV/AIDS pandemic, it was thought that acyclovir and related drugs (valacyclovir, famciclovir) might have significant effect against HIV, not mediated by their anti-HSV effects. However, it did not pan out -- there is no significant action of these drugs against HIV, and they do not interfere with HIV blood testing and do not delay positive HIV test results. There is no reason for you to be taking valacyclovir (Valtrex) if you are not infected with HSV. However, it has had no effect on your HIV blood tests; the negative results prove you were not infected with HIV during the exposure last December. Your negative RNA test in May further confirms you don't have it.

There is rarely a good reason to have CD4 testing in the absence of documented HIV infection. In any case, the fluctuation you have seen in that result is not due to HIV. It might just be normal variation; or perhaps you had a garden variety viral infection along the way. Neither herpes nor HIV is a likely cause of the "burning crawling" sensation in your buttock(s).

You don't mention having seen a doctor about all this. Perhaps you are arranging your own lab tests? If so, I would suggest a) stopping valacyclovir entirely and b) seeing a physician for further evaluation of your symptoms and advice going forward.

I hope this information has been helpful. Let me know if anything isn't clear.

HHH, MD

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97 months ago

In early may and late may I took the last of Valtrex I did 4 generation and hiv rna on June 20. It was negative and I felt I had to wait six months. I have lost six months of my life because of this. So valtrex Would not delay antibody/antigen? My test are final and I can go on.?

H. Hunter Handsfield, MD

97 months ago

As I said above, valacyclovir has no effect on HIV testing and does not delay appearance of either antigen or antibody in the blood. Your results are final and conclusive.

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97 months ago

Your awesome

97 months ago

Hi. This is the new study. Should I be concerned? Leonid Margolis, PhD, After he tested a drug similar to Valtrex, which was formally known as Acyclovir, he saw the drugs still blocked HIV-1 production in the absence of herpes, findings which inspired the present clinical trials. Benigno Rodriguez, MD,studies by these groups helped illuminate exactly how the medication decreases HIV-1 levels. Valacyclovir is activated in virus-infected cells, and then blocks the ability of HIV to reproduce. Thanks Jon

H. Hunter Handsfield, MD

97 months ago

I am aware of the studies by these investigators at NIH. You are over-interpreating the results. They show that in people with longstanding HIV infection, acyclovir and valacyclovir suppress the levels of HIV in the blood. This has been known for a couple of decades; the new aspect is that they have shows it happens as a direct effect on HIV, and not because acyclovir suppresses HSV which in turn helps the immune system fight HIV. Whatever the physioogic reason, the effect was small, far less than the HIV suppression achieved with the drugs used to treat or prevent HIV/AIDS. No HIV/AIDS specialists add acyclovir or valacyclovir to the drug regimens to treat HIV; they are not needed and do not improve treatment outcomes.

Most important to your concerns, these results say absolutely nothing about preventing HIV by taking valacyclovir or acyclovir. It is known that do NOT prevent HIV in exposed persons. Also, there is nothing in these results to suggest that these drugs would alter relaiblity of the HIV antigen or antibody tests or delay positive results with these tests.

A final minor point: acyclovir and valacyclovir are the same drug. Chemically, valacyclovir is a"prodrug" of acyclovir, constructed by adding a molecule of valine, a common amino acid. Valacyclovir is better absorbed into the bloodstream, so it achieve higher blood levels. But during absorption, the valine molecule is cleaved off, producing acyclovir. In other words, acyclovir is what does the work against herpes (and has a slight effect on HIV). Valaclovir itself is entirely inactive; as a prodrug, its just a more sophisticated way of giving acyclovir.

That completes the two follow-up comments and replies included with each initial question and so concludes this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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