Valacyclovir Suppressive Therapy Reduces Plasma and Breast Milk HIV-1 RNA Levels During Pregnancy and Postpartum: A Randomized Trial
Date
2012Author
Drake, Alison L
Roxby, Alison C
Ongecha-Owuor, Francisca
Kiarie, James
John-Stewart, Grace
Wald, Anna
Richardson, Barbra A
Hitti, Jane
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
Background. The effect of herpes simplex virus type 2 (HSV-2) suppression on human immunodeficiency virus type 1 (HIV-1) RNA in the context of prevention of mother-to-child transmission (PMTCT) interventions is unknown.
Methods. Between April 2008 and August 2010, we conducted a randomized, double-blind trial of twice daily 500 mg valacyclovir or placebo beginning at 34 weeks gestation in 148 HIV-1/HSV-2 coinfected pregnant Kenyan women ineligible for highly active antiretroviral therapy (CD4 > 250 cells/mm3). Women received zidovudine and single dose nevirapine for PMTCT and were followed until 12 months postpartum.
Results. Mean baseline plasma HIV-1 RNA was 3.88 log10 copies/mL. Mean plasma HIV-1 was lower during pregnancy (−.56 log10 copies/mL; 95% confidence interval [CI], −.77 to −.34) and after 6 weeks postpartum (−.51 log10 copies/mL; 95% CI, −.73 to −.30) in the valacyclovir arm than the placebo arm. Valacyclovir reduced breast milk HIV-1 RNA detection at 6 and 14 weeks postpartum compared with placebo (30% lower, P = .04; 46% lower, P = .01, respectively), but not after 14 weeks. Cervical HIV-1 RNA detection was similar between arms (P = .91).
Conclusions. Valacyclovir significantly decreased early breast milk and plasma HIV-1 RNA among women receiving PMTCT.
URI
http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/19952http://www.ncbi.nlm.nih.gov/pubmed/22147786
Citation
J Infect Dis. 2012 February 1; 205(3): 366–375.Publisher
Department of Obstetrics and Gynaecology
Description
Full text
Collections
- Faculty of Health Sciences (FHS) [10378]