• Login
    View Item 
    •   UoN Digital Repository Home
    • Journal Articles
    • Faculty of Health Sciences (FHS)
    • View Item
    •   UoN Digital Repository Home
    • Journal Articles
    • Faculty of Health Sciences (FHS)
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Acyclovir and transmission of HIV-1 from persons infected with HIV-1 and HSV-2.

    Thumbnail
    View/Open
    Abstract.pdf (59.26Kb)
    Date
    2010
    Author
    Celum, C
    Corey, L
    Ridzon, R
    Barnes, L
    McElrath, MJ
    Whittington, WL
    Morrow, R
    Coombs, RW
    Thomas, KK
    Campbell, MS
    Stevens, W
    Vwalika, B
    Rees, H
    Delany, S
    Kanweka, W
    Karita, E
    Kayitenkore, K
    Inambao, M
    Allen, S
    Coetzee, D
    Kapiga, S
    Manongi, R
    McIntyre, JA
    Gray, GE
    G, de Bruyn
    Fife, KH
    Were, E
    Essex, M
    Makhema, J
    Stewart, GJ
    Farquhar, C
    Kiarie, J
    Ronald, A
    Katabira, E
    Cohen, CR
    Bukusi, EA
    Hughes, JP
    Mullins, JI
    Baeten, JM
    Mujugira, A
    Mugo, N
    Wang, RS
    Magaret, AS
    Lingappa, JR
    Wald, A
    Type
    Article
    Language
    en
    Metadata
    Show full item record

    Abstract
    Most persons who are infected with human immunodeficiency virus type 1 (HIV-1) are also infected with herpes simplex virus type 2 (HSV-2), which is frequently reactivated and is associated with increased plasma and genital levels of HIV-1. Therapy to suppress HSV-2 reduces the frequency of reactivation of HSV-2 as well as HIV-1 levels, suggesting that suppression of HSV-2 may reduce the risk of transmission of HIV-1. We conducted a randomized, placebo-controlled trial of suppressive therapy for HSV-2 (acyclovir at a dose of 400 mg orally twice daily) in couples in which only one of the partners was seropositive for HIV-1 (CD4 count, > or = 250 cells per cubic millimeter) and that partner was also infected with HSV-2 and was not taking antiretroviral therapy at the time of enrollment. The primary end point was transmission of HIV-1 to the partner who was not initially infected with HIV-1; linkage of transmissions was assessed by means of genetic sequencing of viruses. A total of 3408 couples were enrolled at 14 sites in Africa. Of the partners who were infected with HIV-1, 68% were women, and the baseline median CD4 count was 462 cells per cubic millimeter. Of 132 HIV-1 seroconversions that occurred after randomization (an incidence of 2.7 per 100 person-years), 84 were linked within couples by viral sequencing: 41 in the acyclovir group and 43 in the placebo group (hazard ratio with acyclovir, 0.92, 95% confidence interval [CI], 0.60 to 1.41; P=0.69). Suppression with acyclovir reduced the mean plasma concentration of HIV-1 by 0.25 log(10) copies per milliliter (95% CI, 0.22 to 0.29; P<0.001) and the occurrence of HSV-2-positive genital ulcers by 73% (risk ratio, 0.27; 95% CI, 0.20 to 0.36; P<0.001). A total of 92% of the partners infected with HIV-1 and 84% of the partners not infected with HIV-1 remained in the study for 24 months. The level of adherence to the dispensed study drug was 96%. No serious adverse events related to acyclovir were observed. Daily acyclovir therapy did not reduce the risk of transmission of HIV-1, despite a reduction in plasma HIV-1 RNA of 0.25 log(10) copies per milliliter and a 73% reduction in the occurrence of genital ulcers due to HSV-2. (ClinicalTrials.gov number, NCT00194519.)
    URI
    http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/32619
    http://www.ncbi.nlm.nih.gov/pubmed/20089951
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2838503/
    Citation
    N Engl J Med. 2010 Feb 4;362(5):427-39. doi: 10.1056/NEJMoa0904849. Epub 2010 Jan 20.
    Publisher
    College of Health Sciences
    Collections
    • Faculty of Health Sciences (FHS) [10067]

    Copyright © 2019 
    University of Nairobi Library
    | UoN Quality Policy | Send Feedback
     

    Browse

    All of UoN Digital RepositoryCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjects

    My Account

    LoginRegister

    Copyright © 2019 
    University of Nairobi Library
    | UoN Quality Policy | Send Feedback