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Daily acyclovir to decrease herpes simplex virus type 2 (HSV-2) transmission from HSV-2/HIV-1 coinfected persons: a

Andrew Mujugira1, Amalia S Magaret, Connie Celum

  • 1Department of Global Health.

The Journal of Infectious Diseases
|August 1, 2013
PubMed
Summary
This summary is machine-generated.

Daily acyclovir did not reduce herpes simplex virus type 2 (HSV-2) transmission in African couples coinfected with HIV-1. More effective prevention strategies are needed to curb HSV-2 spread from HIV-1-infected individuals.

Keywords:
AfricaHIV-1HSV-2acyclovirserodiscordant couplestransmission

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Area of Science:

  • Infectious Diseases
  • Virology
  • Public Health

Background:

  • Daily valacyclovir therapy reduces HSV-2 transmission by 48% in serodiscordant heterosexual couples.
  • The impact of suppressive therapy on HSV-2 transmission in individuals coinfected with HSV-2 and HIV-1 remains unknown.

Purpose of the Study:

  • To evaluate the efficacy of daily acyclovir in preventing HSV-2 transmission among African HIV-1 serodiscordant couples.

Main Methods:

  • A randomized trial involving 911 HSV-2/HIV-1 serodiscordant couples in Africa.
  • Participants received either daily acyclovir (400 mg twice daily) or a placebo.
  • Analysis focused on HSV-2 seroconversions in HIV-1-susceptible, HSV-2-seronegative partners.

Main Results:

  • No significant reduction in HSV-2 transmission was observed with daily acyclovir (HR, 1.35; P = .22).
  • HSV-2 incidence was 5.1 cases per 100 person-years.
  • Risk factors for HSV-2 acquisition included vaginal drying practices and unprotected sex in women, and younger age (≤30 years) in men.

Conclusions:

  • Daily suppressive acyclovir treatment did not decrease HSV-2 transmission risk in coinfected African couples.
  • Novel prevention strategies are essential to reduce HSV-2 transmission from HIV-1-infected individuals.