Can Valacyclovir Delay the Need for Initiation of Human Immunodeficiency Virus (HIV) Treatment in HIV-infected Individuals?

Inclusion Criteria: * adult (aged 18 years or older or as per Local/Provincial Guidelines) * documented HIV-1 infection (determined by EIA and Western blot, sites' standard assays are acceptable if approved in advance by the PIs for the study, Dr. Darrell Tan and/or Dr. Sharon Walmsley) * no use of chronic anti-HSV therapy for the past 6 months, and not anticipated to require chronic anti-HSV therapy during the study * antiretroviral naïve (no more than 14 days of total prior ARV exposure) * CD4 count within the 400-900 cells/mm3 range (inclusive) on two consecutive occasions, with at least one measurement within 30 days of initiating trial (baseline visit) * does not meet recommendations for initiating ARV therapy according to current guidelines Exclusion Criteria: * pregnancy or actively planning to become pregnant * receiving chemotherapy, chronic steroid therapy or other immunomodulatory medications (e.g. interferon, azathioprine, methotrexate, TNF-alpha antagonists, etc.) * Estimated creatinine clearance \<30 mL/min * Other medical condition likely to cause death within 24 months * Enrolled in a therapeutic HIV vaccine or immunotherapy trial * Enrolled in another trial investigating the impact of another intervention on HIV disease progression * HIV elite controller (EC), phenotypically defined here as documented duration of HIV infection of ≥5 years, a persistent CD4 cell count ≥500 cells/mm3, and a persistent plasma HIV viral load of \<1000 copies/mL in the absence …