Antivirals in the context of HIV disease

Antiviral drugs, other than those with anti-retroviral activity, are used in persons with human immunodeficiency virus (HIV) infection for two purposes: treatment or prevention of viral infections that cause disease in persons with immunodeficiency, and to suppress viruses that might act as co-factors and promote replication of HIV itself. Human herpesviruses are the major targets of therapy in both settings. The herpesviruses, particularly cytomegalovirus (CMV), herpes simplex virus (HSV) and varicella-zoster virus (VZV) act as opportunistic pathogens as cell-mediated immunity declines, and there is theorectical, in-vitro, and in-vivo evidence that one or more herpesviruses can accelerate the progression of HIV disease. Therapy and prophylaxis with antiherpes compounds such as acyclovir, ganciclovir and foscarnet are well established in HIV infection, and this article will review their present use and recent improvements in formulations and drug delivery.