Impact of Acyclovir on Genital and Plasma HIV-1 RNA, Genital Herpes Simplex Virus Type 2 DNA, and Ulcer Healing among HIV-1–Infected African Women with Herpes Ulcers: A Randomized Placebo-Controlled Trial
Identifieur interne : 000255 ( Istex/Curation ); précédent : 000254; suivant : 000256Impact of Acyclovir on Genital and Plasma HIV-1 RNA, Genital Herpes Simplex Virus Type 2 DNA, and Ulcer Healing among HIV-1–Infected African Women with Herpes Ulcers: A Randomized Placebo-Controlled Trial
Auteurs : Philippe Mayaud [Royaume-Uni] ; Jérôme Legoff ; Helen A. Weiss [Royaume-Uni] ; Gérard Grésenguet [République centrafricaine] ; Khonde Nzambi [Ghana] ; Hicham Bouhlal ; Eric Frost [Canada] ; Jacques Pépin [Canada] ; Jean-Elie Malkin [France] ; Richard J. Hayes [Royaume-Uni] ; David C. W. Mabey ; Laurent BélecSource :
- The Journal of Infectious Diseases [ 0022-1899 ] ; 2009-07-15.
Abstract
BackgroundLittle is known about the impact of episodic treatment of herpes on human immunodeficiency virus type 1 (HIV-1) MethodsWomen from Ghana and the Central African Republic who had genital ulcers were enrolled in a randomized, double-blind, placebo-controlled trial of acyclovir plus antibacterials and were monitored for 28 days. Ulcer etiologies and detection of lesional HIV-1 RNA were determined by polymerase chain reaction (PCR). Cervicovaginal HIV-1 RNA and herpes simplex virus type 2 (HSV-2) DNA and plasma HIV-1 RNA were quantitated by real-time PCR. Primary analyses included 118 HIV-1–infected women with HSV-2 ulcers (54 of whom were given acyclovir and 64 of whom were given placebo) ResultsAcyclovir had little impact on (1) detection of cervicovaginal HIV-1 RNA (risk ratio [RR], 0.96; 95% confidence interval [CI], 0.8–1.2) at day 7 of treatment, (2) the mean cervicovaginal HIV-1 RNA load (−0.06 log10 copies/mL; 95% CI, −0.4 to 0.3 log10 copies/mL) at day 7 of treatment, or (3) the plasma HIV-1 RNA load (+0.09 log10 copies/mL; 95% CI, −0.1 to 0.3 log10 copies/mL) at day 14 of treatment. At day 7, women receiving acyclovir were less likely to have detectable lesional HIV-1 RNA (RR, 0.70; 95% CI, 0.4–1.2) or cervicovaginal HSV-2 DNA (RR, 0.69; 95% CI, 0.4–1.3), had a lower quantity of HSV-2 DNA (−0.99 log10 copies/mL; 95% CI, −1.8 to −0.2 log10 copies/mL), and were more likely to have a healed ulcer (RR, 1.26; 95% CI, 0.9–1.9) ConclusionEpisodic therapy for herpes reduced the quantity of cervicovaginal HSV-2 DNA and slightly improved ulcer healing, but it did not decrease genital and plasma HIV-1 RNA loads Trial registrationClinicalTrials.gov identifier NCT00158483
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DOI: 10.1086/599991
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Jérôme Legoff<affiliation><mods:affiliation>Université Paris Diderot, Laboratoire de Microbiologie, Hôpital Saint-Louis, and</mods:affiliation><wicri:noCountry code="subField">and</wicri:noCountry></affiliation><affiliation><mods:affiliation>Université Paris Descartes, Equipe Immunité et Biothérapie Muqueuse, Unité INSERM Internationale U743 (Immunologie Humaine), Centre de Recherches Biomédicales des Cordeliers and Laboratoire de Virologie, Hôpital Européen Georges Pompidou,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Clinical Research Unit, Department of Infectious and Tropical Diseases, and</mods:affiliation><wicri:noCountry code="subField">and</wicri:noCountry></affiliation><affiliation><mods:affiliation>Université Paris Descartes, Equipe Immunité et Biothérapie Muqueuse, Unité INSERM Internationale U743 (Immunologie Humaine), Centre de Recherches Biomédicales des Cordeliers and Laboratoire de Virologie, Hôpital Européen Georges Pompidou,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation>Le document en format XML
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Mabey</name><affiliation><mods:affiliation>Clinical Research Unit, Department of Infectious and Tropical Diseases, and</mods:affiliation><wicri:noCountry code="subField">and</wicri:noCountry></affiliation></author><author><name sortKey="Belec, Laurent" sort="Belec, Laurent" uniqKey="Belec L" first="Laurent" last="Bélec">Laurent Bélec</name><affiliation><mods:affiliation>Université Paris Descartes, Equipe Immunité et Biothérapie Muqueuse, Unité INSERM Internationale U743 (Immunologie Humaine), Centre de Recherches Biomédicales des Cordeliers and Laboratoire de Virologie, Hôpital Européen Georges Pompidou,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:A8D7F03BC8675B8AACE47022187702C7B7DE22EE</idno><date when="2009" year="2009">2009</date><idno type="doi">10.1086/599991</idno><idno type="url">https://api.istex.fr/document/A8D7F03BC8675B8AACE47022187702C7B7DE22EE/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">000255</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000255</idno><idno type="wicri:Area/Istex/Curation">000255</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Impact of Acyclovir on Genital and Plasma HIV-1 RNA, Genital Herpes Simplex Virus Type 2 DNA, and Ulcer Healing among HIV-1–Infected African Women with Herpes Ulcers: A Randomized Placebo-Controlled Trial</title><author><name sortKey="Mayaud, Philippe" sort="Mayaud, Philippe" uniqKey="Mayaud P" first="Philippe" last="Mayaud">Philippe Mayaud</name><affiliation><mods:affiliation>Clinical Research Unit, Department of Infectious and Tropical Diseases, and</mods:affiliation></affiliation><affiliation wicri:level="1"><mods:affiliation>Reprints or correspondence: Philippe Mayaud, Clinical Research Unit, London School of Hygiene & Tropical Medicine, Keppel St., London WC1E 7HT, UK (philippe.mayaud@lshtm.ac.uk)</mods:affiliation><country>Royaume-Uni</country><wicri:regionArea>Reprints or correspondence: Philippe Mayaud, Clinical Research Unit, London School of Hygiene & Tropical Medicine, Keppel St., London WC1E 7HT</wicri:regionArea></affiliation></author><author><name sortKey="Legoff, Jerome" sort="Legoff, Jerome" uniqKey="Legoff J" first="Jérôme" last="Legoff">Jérôme Legoff</name><affiliation><mods:affiliation>Université Paris Descartes, Equipe Immunité et Biothérapie Muqueuse, Unité INSERM Internationale U743 (Immunologie Humaine), Centre de Recherches Biomédicales des Cordeliers and Laboratoire de Virologie, Hôpital Européen Georges Pompidou,</mods:affiliation></affiliation><affiliation><mods:affiliation>Université Paris Diderot, Laboratoire de Microbiologie, Hôpital Saint-Louis, and</mods:affiliation><wicri:noCountry code="subField">and</wicri:noCountry></affiliation></author><author><name sortKey="Weiss, Helen A" sort="Weiss, Helen A" uniqKey="Weiss H" first="Helen A." last="Weiss">Helen A. Weiss</name><affiliation wicri:level="1"><mods:affiliation>Infectious Disease Epidemiology Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom;</mods:affiliation><country xml:lang="fr" wicri:curation="lc">Royaume-Uni</country><wicri:regionArea>Infectious Disease Epidemiology Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London</wicri:regionArea></affiliation></author><author><name sortKey="Gresenguet, Gerard" sort="Gresenguet, Gerard" uniqKey="Gresenguet G" first="Gérard" last="Grésenguet">Gérard Grésenguet</name><affiliation wicri:level="1"><mods:affiliation>Centre National de Référence des Maladies Sexuellement Transmissibles et du SIDA de Bangui and Unité de Recherches et d’Intervention sur les Maladies Sexuellement Transmissibles et du SIDA, Faculté des Sciences de la Santé, Bangui, Central African Republic;</mods:affiliation><country xml:lang="fr" wicri:curation="lc">République centrafricaine</country><wicri:regionArea>Centre National de Référence des Maladies Sexuellement Transmissibles et du SIDA de Bangui and Unité de Recherches et d’Intervention sur les Maladies Sexuellement Transmissibles et du SIDA, Faculté des Sciences de la Santé, Bangui</wicri:regionArea></affiliation></author><author><name sortKey="Nzambi, Khonde" sort="Nzambi, Khonde" uniqKey="Nzambi K" first="Khonde" last="Nzambi">Khonde Nzambi</name><affiliation wicri:level="1"><mods:affiliation>West African Project To Combat AIDS and STIs, Accra, Ghana;</mods:affiliation><country xml:lang="fr" wicri:curation="lc">Ghana</country><wicri:regionArea>West African Project To Combat AIDS and STIs, Accra</wicri:regionArea></affiliation></author><author><name sortKey="Bouhlal, Hicham" sort="Bouhlal, Hicham" uniqKey="Bouhlal H" first="Hicham" last="Bouhlal">Hicham Bouhlal</name><affiliation><mods:affiliation>Université Paris Descartes, Equipe Immunité et Biothérapie Muqueuse, Unité INSERM Internationale U743 (Immunologie Humaine), Centre de Recherches Biomédicales des Cordeliers and Laboratoire de Virologie, Hôpital Européen Georges Pompidou,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Frost, Eric" sort="Frost, Eric" uniqKey="Frost E" first="Eric" last="Frost">Eric Frost</name><affiliation wicri:level="1"><mods:affiliation>Centre for International Health, University of Sherbrooke, Sherbrooke, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Centre for International Health, University of Sherbrooke, Sherbrooke</wicri:regionArea></affiliation></author><author><name sortKey="Pepin, Jacques" sort="Pepin, Jacques" uniqKey="Pepin J" first="Jacques" last="Pépin">Jacques Pépin</name><affiliation wicri:level="1"><mods:affiliation>Centre for International Health, University of Sherbrooke, Sherbrooke, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Centre for International Health, University of Sherbrooke, Sherbrooke</wicri:regionArea></affiliation></author><author><name sortKey="Malkin, Jean Elie" sort="Malkin, Jean Elie" uniqKey="Malkin J" first="Jean-Elie" last="Malkin">Jean-Elie Malkin</name><affiliation wicri:level="1"><mods:affiliation>Centre Médical, Institut Pasteur, Paris, France;</mods:affiliation><country xml:lang="fr" wicri:curation="lc">France</country><wicri:regionArea>Centre Médical, Institut Pasteur, Paris</wicri:regionArea></affiliation></author><author><name sortKey="Hayes, Richard J" sort="Hayes, Richard J" uniqKey="Hayes R" first="Richard J." last="Hayes">Richard J. Hayes</name><affiliation wicri:level="1"><mods:affiliation>Infectious Disease Epidemiology Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom;</mods:affiliation><country xml:lang="fr" wicri:curation="lc">Royaume-Uni</country><wicri:regionArea>Infectious Disease Epidemiology Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London</wicri:regionArea></affiliation></author><author><name sortKey="Mabey, David C W" sort="Mabey, David C W" uniqKey="Mabey D" first="David C. W." last="Mabey">David C. W. Mabey</name><affiliation><mods:affiliation>Clinical Research Unit, Department of Infectious and Tropical Diseases, and</mods:affiliation><wicri:noCountry code="subField">and</wicri:noCountry></affiliation></author><author><name sortKey="Belec, Laurent" sort="Belec, Laurent" uniqKey="Belec L" first="Laurent" last="Bélec">Laurent Bélec</name><affiliation><mods:affiliation>Université Paris Descartes, Equipe Immunité et Biothérapie Muqueuse, Unité INSERM Internationale U743 (Immunologie Humaine), Centre de Recherches Biomédicales des Cordeliers and Laboratoire de Virologie, Hôpital Européen Georges Pompidou,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author></analytic><monogr></monogr><series><title level="j">The Journal of Infectious Diseases</title><title level="j" type="abbrev">The Journal of Infectious Diseases</title><idno type="ISSN">0022-1899</idno><idno type="eISSN">1537-6613</idno><imprint><publisher>The University of Chicago Press</publisher><date type="published" when="2009-07-15">2009-07-15</date><biblScope unit="volume">200</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="216">216</biblScope><biblScope unit="page" to="226">226</biblScope></imprint><idno type="ISSN">0022-1899</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-1899</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">BackgroundLittle is known about the impact of episodic treatment of herpes on human immunodeficiency virus type 1 (HIV-1) MethodsWomen from Ghana and the Central African Republic who had genital ulcers were enrolled in a randomized, double-blind, placebo-controlled trial of acyclovir plus antibacterials and were monitored for 28 days. Ulcer etiologies and detection of lesional HIV-1 RNA were determined by polymerase chain reaction (PCR). Cervicovaginal HIV-1 RNA and herpes simplex virus type 2 (HSV-2) DNA and plasma HIV-1 RNA were quantitated by real-time PCR. Primary analyses included 118 HIV-1–infected women with HSV-2 ulcers (54 of whom were given acyclovir and 64 of whom were given placebo) ResultsAcyclovir had little impact on (1) detection of cervicovaginal HIV-1 RNA (risk ratio [RR], 0.96; 95% confidence interval [CI], 0.8–1.2) at day 7 of treatment, (2) the mean cervicovaginal HIV-1 RNA load (−0.06 log10 copies/mL; 95% CI, −0.4 to 0.3 log10 copies/mL) at day 7 of treatment, or (3) the plasma HIV-1 RNA load (+0.09 log10 copies/mL; 95% CI, −0.1 to 0.3 log10 copies/mL) at day 14 of treatment. At day 7, women receiving acyclovir were less likely to have detectable lesional HIV-1 RNA (RR, 0.70; 95% CI, 0.4–1.2) or cervicovaginal HSV-2 DNA (RR, 0.69; 95% CI, 0.4–1.3), had a lower quantity of HSV-2 DNA (−0.99 log10 copies/mL; 95% CI, −1.8 to −0.2 log10 copies/mL), and were more likely to have a healed ulcer (RR, 1.26; 95% CI, 0.9–1.9) ConclusionEpisodic therapy for herpes reduced the quantity of cervicovaginal HSV-2 DNA and slightly improved ulcer healing, but it did not decrease genital and plasma HIV-1 RNA loads Trial registrationClinicalTrials.gov identifier NCT00158483</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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