Impact of Acyclovir on Genital and Plasma HIV-1 RNA, Genital Herpes Simplex Virus Type 2 DNA, and Ulcer Healing among HIV-1바카라 사이트Infected African Women with Herpes Ulcers: A Randomized Placebo-Controlled Trial.
Abstract
Background: Little is known about the impact of episodic treatment of herpes on human immunodeficiency virus type 1 (HIV바카라 사이트1). Methods: Women from Ghana and the Central African Republic who had genital ulcers were enrolled in a randomized, double바카라 사이트blind, placebo바카라 사이트controlled trial of acyclovir plus antibacterials and were monitored for 28 days. Ulcer etiologies and detection of lesional HIV바카라 사이트1 RNA were determined by polymerase chain reaction (PCR). Cervicovaginal HIV바카라 사이트1 RNA and herpes simplex virus type 2 (HSV바카라 사이트2) DNA and plasma HIV바카라 사이트1 RNA were quantitated by real바카라 사이트time PCR. Primary analyses included 118 HIV바카라 사이트1바카라 사이트infected women with HSV바카라 사이트2 ulcers (54 of whom were given acyclovir and 64 of whom were given placebo). Results: Acyclovir had little impact on (1) detection of cervicovaginal HIV바카라 사이트1 RNA (risk ratio [RR], 0.96; 95% confidence interval [CI], 0.8바카라 사이트1.2) at day 7 of treatment, (2) the mean cervicovaginal HIV바카라 사이트1 RNA load (−0.06 log<sub>10</sub> copies/mL; 95% CI, −0.4 to 0.3 log<sub>10</sub> copies/mL) at day 7 of treatment, or (3) the plasma HIV바카라 사이트1 RNA load (+0.09 log<sub>10</sub> copies/mL; 95% CI, −0.1 to 0.3 log<sub>10</sub> copies/mL) at day 14 of treatment. At day 7, women receiving acyclovir were less likely to have detectable lesional HIV바카라 사이트1 RNA (RR, 0.70; 95% CI, 0.4바카라 사이트1.2) or cervicovaginal HSV바카라 사이트2 DNA (RR, 0.69; 95% CI, 0.4바카라 사이트1.3), had a lower quantity of HSV바카라 사이트2 DNA (−0.99 log<sub>10</sub> copies/mL; 95% CI, −1.8 to −0.2 log<sub>10</sub> copies/mL), and were more likely to have a healed ulcer (RR, 1.26; 95% CI, 0.9바카라 사이트1.9). Conclusion: Episodic therapy for herpes reduced the quantity of cervicovaginal HSV바카라 사이트2 DNA and slightly improved ulcer healing, but it did not decrease genital and plasma HIV바카라 사이트1 RNA loads. [See also the reporting on this study].
Citation
Mayaud, P.; Legoff, J.; Weiss, H.A.; Grésenguet, G.; Nzambi, K.; Bouhlal, H.; Frost, E.; Pépin, J.; Malkin, J.E.; Hayes, R.J.; Bélec, L.; Mabey, D.C.W.; ANRS 1212 Study Group. Impact of Acyclovir on Genital and Plasma HIV&#8208;1 RNA, Genital Herpes Simplex Virus Type 2 DNA, and Ulcer Healing among HIV&#8208;1&#8211;Infected African Women with Herpes Ulcers: A Randomized Placebo&#8208;Controlled Trial. Journal of Infectious Diseases (2009) 200 (2) 216-226. [DOI: 10.1086/599991]