dc.contributor.author | Mugwanya, K | |
dc.contributor.author | Baeten, JM | |
dc.contributor.author | Mugo, NR | |
dc.contributor.author | Irungu, E | |
dc.contributor.author | Ngure, K | |
dc.contributor.author | Celum, C | |
dc.date.accessioned | 2013-06-13T07:13:10Z | |
dc.date.available | 2013-06-13T07:13:10Z | |
dc.date.issued | 2011 | |
dc.identifier.citation | High-dose valacyclovir HSV-2 suppression results in greater reduction in plasma HIV-1 levels compared with standard dose acyclovir among HIV-1/HSV-2 coinfected persons: a randomized, crossover trial. Mugwanya K, Baeten JM, Mugo NR, Irungu E, Ngure K, Celum C. J Infect Dis. 2011 Dec 15;204(12):1912-7. doi: 10.1093/infdis/jir649. Epub 2011 Oct 12. | en |
dc.identifier.govdoc | http://hinari-gw.who.int/whalecomwww.ncbi.nlm.nih.gov/whalecom0/pubmed/21998479 | |
dc.identifier.uri | http://hdl.handle.net/11295/32709 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/pubmed/21998479 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3247811/ | |
dc.description.abstract | Standard-dose HSV-2 suppressive therapy (acyclovir 400 mg twice daily) reduces plasma HIV-1 levels by 0.25-0.50 log(10) copies/mL. It is not known if higher doses might further suppress HIV-1 levels.
METHODS:
We enrolled 32 HIV-1/HSV-2 dually infected Kenyan individuals who were not on antiretroviral therapy (ART) into a randomized, crossover trial of 2 dosing regimens of HSV-2 suppression: valacyclovir 1.5 g vs acyclovir 400 mg, both twice daily for 12 weeks, then a 2-week washout, and then the alternative for 12 weeks. Weekly plasma HIV-1 RNA quantity was measured (ClinicalTrials.gov number NCT01026454).
RESULTS:
Mean plasma HIV-1 levels were significantly lower on valacyclovir compared with acyclovir: 2.94 vs 3.56 log(10) copies/mL, an average difference of 0.62 log(10) copies/mL (95% confidence interval [CI]: -0.68, -0.55; P < .001), a 76% decrease. Valacyclovir resulted in a 1.23 log(10) copies/mL decrease compared with baseline HIV-1 levels without HSV-2 suppression. Adherence was similar (99.4% of dispensed study tablets taken), and high-dose valacyclovir was well tolerated.
CONCLUSIONS:
High-dose valacyclovir reduced plasma HIV-1 viral levels by 0.62 log(10) copies/mL compared with standard-dose acyclovir. The potential for higher-dose HSV-2 suppressive therapy to slow HIV-1 disease progression and reduce HIV-1 infectiousness among HIV-1/HSV-2 coinfected persons not yet eligible for ART warrants further evaluation. | en |
dc.language.iso | en | en |
dc.title | High-dose valacyclovir HSV-2 suppression results in greater reduction in plasma HIV-1 levels compared with standard dose acyclovir among HIV-1/HSV-2 coinfected persons: a randomized, crossover trial. | en |
dc.type | Article | en |
local.publisher | Infectious Diseases Institute, Makerere University, Kampala, Uganda | en |