Effect of HSV-2 Suppressive Therapy on Genital Tract HIV-1 RNA Shedding among Women on HAART: A Pilot Randomized Controlled Trial

Autor: Aadia Rana, Ank E. Nijhawan, Jaclynn Kurpewski, Susan Cu-Uvin, Allison DeLong, Jessica Ingersoll, Angela M. Caliendo, Stacey Chapman
Rok vydání: 2012
Předmět:
viruses
Herpesvirus 2
Human
Acyclovir
HIV Infections
Pilot Projects
HSL and HSV
law.invention
0302 clinical medicine
Randomized controlled trial
law
Antiretroviral Therapy
Highly Active
030212 general & internal medicine
Young adult
0303 health sciences
Coinfection
virus diseases
Obstetrics and Gynecology
Genitalia
Female
Middle Aged
Viral Load
Virus Shedding
3. Good health
Infectious Diseases
RNA
Viral
Regression Analysis
Female
medicine.symptom
Viral load
Adult
medicine.medical_specialty
Sexual transmission
Article Subject
education
Dermatology
lcsh:Gynecology and obstetrics
Antiviral Agents
behavioral disciplines and activities
Asymptomatic
lcsh:Infectious and parasitic diseases
Young Adult
03 medical and health sciences
Internal medicine
medicine
Humans
lcsh:RC109-216
Viral shedding
lcsh:RG1-991
Herpes Genitalis
030306 microbiology
business.industry
medicine.disease
DNA
Viral
Immunology
HIV-1
Clinical Study
business
Zdroj: Infectious Diseases in Obstetrics and Gynecology
Infectious Diseases in Obstetrics and Gynecology, Vol 2012 (2012)
ISSN: 1098-0997
1064-7449
Popis: Background. The role of suppressive HSV therapy in women coinfected with HSV-2 and HIV-1 taking highly active antiretroviral therapy (HAART) is unclear.Methods. 60 women with HIV-1/HSV-2 coinfection on HAART with plasma HIV-1 viral load (PVL) ≤75 copies/mL were randomized to receive acyclovir (N=30) or no acyclovir (N=30). PVL, genital tract (GT) HIV-1, and GT HSV were measured every 4 weeks for one year.Results. Detection of GT HIV-1 was not significantly different in the two arms (OR 1.23,P=0.67), although this pilot study was underpowered to detect this difference. When PVL was undetectable, the odds of detecting GT HIV were 0.4 times smaller in the acyclovir arm than in the control arm, though this was not statistically significant (P=0.07). The odds of detecting GT HSV DNA in women receiving acyclovir were significantly lower than in women in the control group, OR 0.38,P<0.05.Conclusions. Chronic suppressive therapy with acyclovir in HIV-1/HSV-2-positive women on HAART significantly reduces asymptomatic GT HSV shedding, though not GT HIV shedding or PVL. PVL was strongly associated with GT HIV shedding, reinforcing the importance of HAART in decreasing HIV sexual transmission.
Databáze: OpenAIRE
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