TY - JOUR
AU - ,
AB - Background.Daily suppressive therapy with valacyclovir reduces risk of sexual transmission of herpes simplex virus type 2 (HSV-2) in HSV-2serodiscordant heterosexual couples by 48. Whether suppressive therapy reduces HSV-2 transmission from persons coinfected with HSV-2 and human immunodeficiency virus type 1 (HIV-1) is unknown.Methods.Within a randomized trial of daily acyclovir 400 mg twice daily in African HIV-1 serodiscordant couples, in which the HIV-1infected partner was HSV-2 seropositive, we identified partnerships in which HIV-1susceptible partners were HSV-2 seronegative to estimate the effect of acyclovir on risk of HSV-2 transmission.Results.We randomly assigned 911 HSV-2/HIV-1serodiscordant couples to daily receipt of acyclovir or placebo. We observed 68 HSV-2 seroconversions, 40 and 28 in acyclovir and placebo groups, respectively (HSV-2 incidence, 5.1 cases per 100 person-years; hazard ratio [HR], 1.35 [95 confidence interval, .832.20]; P  .22). Among HSV-2susceptible women, vaginal drying practices (adjusted HR, 44.35; P  .004) and unprotected sex (adjusted HR, 9.91; P  .002) were significant risk factors for HSV-2 acquisition; having more children was protective (adjusted HR, 0.47 per additional child; P  .012). Among HSV-2susceptible men, only age 30 years was associated with increased risk of HSV-2 acquisition (P  .016).Conclusions.Treatment of African HSV-2/HIV-1infected persons with daily suppressive acyclovir did not decrease risk of HSV-2 transmission to susceptible partners. More-effective prevention strategies to reduce HSV-2 transmission from HIV-1infected persons are needed.
TI - Daily Acyclovir to Decrease Herpes Simplex Virus Type 2 (HSV-2) Transmission from HSV-2/HIV-1 Coinfected Persons: A Randomized Controlled Trial
JO - Journal of Infectious Diseases
DO - 10.1093/infdis/jit333
DA - 2013-11-01
UR - https://www.deepdyve.com/lp/oxford-university-press/daily-acyclovir-to-decrease-herpes-simplex-virus-type-2-hsv-2-mbDSZ05tbs
SP - 1366
EP - 1374
VL - 208
IS - 9
DP - DeepDyve
ER -