Effect of Herpes Simplex Suppression on Incidence of HIV Among Women in Tanzania
March 27, 2008
Given that infection with herpes simplex virus type 2 (HSV-2) is associated with an increased risk of acquiring HIV, the current study tested whether therapy to suppress HSV-2 might reduce the risk of HIV acquisition.
In all, 821 women participated and were randomly assigned to receive acyclovir (400 women) or a placebo (421 women). Eighty-three percent (n=679) completed follow-up; mean follow-up was 1.52 years for the acyclovir group and 1.62 years for the placebo group.
HIV infection incidence was 4.27 per 100 person-years (27 women in the acyclovir group, 28 in the placebo group). There was no overall effect of acyclovir on the incidence of HIV (rate ratio for the acyclovir group, 1.08; 95 percent confidence interval, 0.64-1.83). Median adherence was estimated at 90 percent. At six, 12 and 24 months, genital HSV was detected in a similar proportion of women in the two groups. There were no serious adverse events attributable to acyclovir.
"These data show no evidence that acyclovir (400mg twice daily) as HSV suppressive therapy decreases the incidence of infection with HIV," the authors concluded.
New England Journal of Medicine
03.12.2008; doi: 10.1056/NEJMoa0800260; Deborah Watson-Jones, M.D., Ph.D.; Helen A. Weiss, Ph.D.; Mary Rusizoka, Dip. Med.; John Changalucha, M.Sc.; Kathy Baisley, M.Sc.; Kokugonza Mugeye, Dip. Med.; Clare Tanton, M.Sc.; David Ross, M.D., Ph.D.; Dean Everett, Ph.D.; Tim Clayton, M.Sc.; Rebecca Balira, M.Sc.; Louise Knight, M.Sc.; Ian Hambleton, Ph.D.; Jerome Le Goff, M.Sc., Ph.D.; Laurent Belec, M.Sc., Ph.D.; Richard Hayes, D.Sc.
The Role of Herpes Simplex Virus Type 2 and Other Genital Infections in the Acquisition of HIV-1 Among High-Risk Women in Northern Tanzania
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.