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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Reduction of HIV-1 RNA levels with therapy to suppress herpes simplex virus
New England Journal of Medicine, Volume 356, No. 8, Year 2007
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Description
BACKGROUND: Epidemiologic data suggest that infection with herpes simplex virus type 2 (HSV-2) is associated with increased genital shedding of human immunodeficiency virus type 1 (HIV-1) RNA and HIV-1 transmissibility. METHODS: We conducted a randomized, double-blind, placebo-controlled trial of HSV suppressive therapy with valacyclovir (at a dose of 500 mg twice daily) in Burkina Faso among women who were seropositive for HIV-1 and HSV-2; all were ineligible for highly active antiretroviral therapy. The patients were followed for 24 weeks (12 weeks before and 12 weeks after randomization). Regression models were used to assess the effect of valacyclovir on the presence and quantity of genital and plasma HIV-1 RNA and genital HSV-2 DNA during treatment, adjusting for baseline values, and to evaluate the effect over time. RESULTS: A total of 140 women were randomly assigned to treatment groups; 136 were included in the analyses. At enrollment, the median CD4 cell count was 446 cells per cubic millimeter, and the mean plasma viral load was 4.44 log10 copies per milliliter. With the use of summary-measures analysis, valacyclovir therapy was found to be associated with a significant decrease in the frequency of genital HIV-1 RNA (odds ratio, 0.41; 95% confidence interval [CI], 0.21 to 0.80) and in the mean quantity of the virus (log10 copies per milliliter, -0.29; 95% CI, -0.44 to -0.15). However, there was no significant decrease in detection of HIV (risk ratio, 0.93; 95% CI, 0.81 to 1.07). HSV suppressive therapy also reduced the mean plasma HIV-1 RNA level by 0.53 log10 copy per milliliter (95% CI, -0.72 to -0.35). Repeated-measures analysis showed that these effects became significantly stronger during the 3 months of follow-up. CONCLUSIONS: HSV suppressive therapy significantly reduces genital and plasma HIV-1 RNA levels in dually infected women. This finding may have important implications for HIV control. Copyright © 2007 Massachusetts Medical Society.
Authors & Co-Authors
Nagot, Nicolas
Unknown Affiliation
Ouédraogo, Abdoulaye V.
Unknown Affiliation
Foulongne, Vincent
Unknown Affiliation
Konaté, Issouf
Unknown Affiliation
Weiss, Helen Anne
Unknown Affiliation
Vergne, Laurence
Unknown Affiliation
Defer, Marie Christine
Unknown Affiliation
Djagbaré, Didier
Unknown Affiliation
Sanon, Anselme
Unknown Affiliation
Andonaba, Jean Baptiste
Unknown Affiliation
Becquart, Pierre
Unknown Affiliation
Segondy, Michel
Unknown Affiliation
Vallo, Roselyne
Unknown Affiliation
Sawadogo, Adrien Bruno
Unknown Affiliation
van de Perre, Philippe
Unknown Affiliation
Mayaud, Philippe C.
Unknown Affiliation
Statistics
Citations: 378
Authors: 16
Affiliations: 5
Identifiers
Doi:
10.1056/NEJMoa062607
ISSN:
00284793
e-ISSN:
15334406
Research Areas
Disability
Genetics And Genomics
Infectious Diseases
Sexual And Reproductive Health
Study Design
Randomised Control Trial
Cohort Study
Case-Control Study
Study Locations
Burkina Faso
Participants Gender
Female