Once-Daily Valacyclovir to Reduce the Risk of Transmission of Genital Herpes
| Autor: | Anna Wald, Raj Patel, Leonid S. Stratchounsky, Stephen L. Sacks, Terri Warren, Stephen K. Tyring, Karl R. Beutner, Helen A. Watson, R. Ashley Morrow, John M. Douglas, Lawrence Corey, Oliver N. Keene, Dereck Tait, Mauricio Vargas-Cortes, Gregory J. Mertz, Jorma Paavonen |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male Safe Sex medicine.medical_specialty Sexual transmission Adolescent Herpesvirus 2 Human viruses Acyclovir medicine.disease_cause Antiviral Agents Drug Administration Schedule 03 medical and health sciences 0302 clinical medicine Internal medicine Disease Transmission Infectious Humans Medicine Sex organ 030212 general & internal medicine Herpes Genitalis Aged Herpes Simplex Virus Vaccines 0303 health sciences 030306 microbiology Transmission (medicine) business.industry Valine General Medicine Middle Aged 3. Good health Valaciclovir Herpes simplex virus Valacyclovir Immunology Female Virus Activation Viral disease business medicine.drug |
| Zdroj: | New England Journal of Medicine. 350:11-20 |
| ISSN: | 1533-4406 0028-4793 |
| Popis: | Nucleoside analogues against herpes simplex virus (HSV) have been shown to suppress shedding of HSV type 2 (HSV-2) on genital mucosal surfaces and may prevent sexual transmission of HSV.We followed 1484 immunocompetent, heterosexual, monogamous couples: one with clinically symptomatic genital HSV-2 and one susceptible to HSV-2. The partners with HSV-2 infection were randomly assigned to receive either 500 mg of valacyclovir once daily or placebo for eight months. The susceptible partner was evaluated monthly for clinical signs and symptoms of genital herpes. Source partners were followed for recurrences of genital herpes; 89 were enrolled in a substudy of HSV-2 mucosal shedding. Both partners were counseled on safer sex and were offered condoms at each visit. The predefined primary end point was the reduction in transmission of symptomatic genital herpes.Clinically symptomatic HSV-2 infection developed in 4 of 743 susceptible partners who were given valacyclovir, as compared with 16 of 741 who were given placebo (hazard ratio, 0.25; 95 percent confidence interval, 0.08 to 0.75; P=0.008). Overall, acquisition of HSV-2 was observed in 14 of the susceptible partners who received valacyclovir (1.9 percent), as compared with 27 (3.6 percent) who received placebo (hazard ratio, 0.52; 95 percent confidence interval, 0.27 to 0.99; P=0.04). HSV DNA was detected in samples of genital secretions on 2.9 percent of the days among the HSV-2-infected (source) partners who received valacyclovir, as compared with 10.8 percent of the days among those who received placebo (P0.001). The mean rates of recurrence were 0.11 per month and 0.40 per month, respectively (P0.001).Once-daily suppressive therapy with valacyclovir significantly reduces the risk of transmission of genital herpes among heterosexual, HSV-2-discordant couples. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|