Impact of Acyclovir on Genital and Plasma HIV-1 RNA, Genital Herpes Simplex Virus Type 2 DNA, and Ulcer Healing among HIV-1-Infected African Women with Herpes Ulcers: A Randomized Placebo-Controlled Trial. The Journal of infectious diseases [J Infect Dis] Journal article | | Title | Impact of Acyclovir on Genital and Plasma HIV-1 RNA, Genital Herpes Simplex Virus Type 2 DNA, and Ulcer Healing among HIV-1-Infected African Women with Herpes Ulcers: A Randomized Placebo-Controlled Trial. | | Author(s) | Mayaud P, Legoff J, Weiss HA, Grésenguet G, Nzambi K, Bouhlal H, Frost E, Pépin J, Malkin JE, Hayes RJ, Mabey DC, Bélec L, ANRS 1212 Study Group | | Institution | Clinical Research Unit, Department of Infectious and Tropical Diseases, and 2Infectious Disease Epidemiology Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom; 3Université Paris Descartes, Equipe Immunité et Biothérapie Muqueuse, Unité INSERM Internationale U743 (Immunologie Humaine), Centre de Recherches Biomédicales des Cordeliers and Laboratoire de Virologie, Hôpital Européen Georges Pompidou, 4Université Paris Diderot, Laboratoire de Microbiologie, Hôpital Saint-Louis, and 5Centre Médical, Institut Pasteur, Paris, France; 6Centre National de Référence des Maladies Sexuellement Transmissibles et du SIDA de Bangui and Unité de Recherches et d'Intervention sur les Maladies Sexuellement Transmissibles et du SIDA, Faculté des Sciences de la Santé, Bangui, Central African Republic; 7West African Project To Combat AIDS and STIs, Accra, Ghana; 8Centre for International Health, University of Sherbrooke, Sherbrooke, Canada. | | Source | J Infect Dis 2009 Jul 15; 200(2):216-226. | | Abstract | Background. Little is known about the impact of episodic treatment of herpes on human immunodeficiency virus type 1 (HIV-1). Methods. Women from Ghana and the Central African Republic who had genital ulcers were enrolled in a randomized, double-blind, placebo-controlled trial of acyclovir plus antibacterials and were monitored for 28 days. Ulcer etiologies and detection of lesional HIV-1 RNA were determined by polymerase chain reaction (PCR). Cervicovaginal HIV-1 RNA and herpes simplex virus type 2 (HSV-2) DNA and plasma HIV-1 RNA were quantitated by real-time PCR. Primary analyses included 118 HIV-1-infected women with HSV-2 ulcers (54 of whom were given acyclovir and 64 of whom were given placebo).
Results. Acyclovir had little impact on (1) detection of cervicovaginal HIV-1 RNA (risk ratio [RR], 0.96; 95% confidence interval [CI], 0.8-1.2) at day 7 of treatment, (2) the mean cervicovaginal HIV-1 RNA load (-0.06 log(10) copies/mL; 95% CI, -0.4 to 0.3 log(10) copies/mL) at day 7 of treatment, or (3) the plasma HIV-1 RNA load (+0.09 log(10) copies/mL; 95% CI, -0.1 to 0.3 log(10) copies/mL) at day 14 of treatment. At day 7, women receiving acyclovir were less likely to have detectable lesional HIV-1 RNA (RR, 0.70; 95% CI, 0.4-1.2) or cervicovaginal HSV-2 DNA (RR, 0.69; 95% CI, 0.4-1.3), had a lower quantity of HSV-2 DNA (-0.99 log(10) copies/mL; 95% CI, -1.8 to -0.2 log(10) copies/mL), and were more likely to have a healed ulcer (RR, 1.26; 95% CI, 0.9-1.9).
Conclusion. Episodic therapy for herpes reduced the quantity of cervicovaginal HSV-2 DNA and slightly improved ulcer healing, but it did not decrease genital and plasma HIV-1 RNA loads. Trial registration. ClinicalTrials.gov identifier NCT00158483 . | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19530940 |
|
|
| |
Advertise on this site.
| | |
|
