Episodic therapy for genital herpes in sub-saharan Africa: a pooled analysis from three randomized controlled trials.
Identifieur interne : 000672 ( PubMed/Corpus ); précédent : 000671; suivant : 000673Episodic therapy for genital herpes in sub-saharan Africa: a pooled analysis from three randomized controlled trials.
Auteurs : Helen A. Weiss ; Gabriela Paz Bailey ; Sam Phiri ; Gerard Gresenguet ; Jerome Legoff ; Jacques Pepin ; David A. Lewis ; Laurent Belec ; Irving F. Hoffman ; William C. Miller ; Philippe MayaudSource :
- PloS one [ 1932-6203 ] ; 2011.
English descriptors
- KwdEn :
- Acyclovir (therapeutic use), Adolescent, Adult, Africa South of the Sahara, Female, HIV Seropositivity (complications), HIV-1 (drug effects), HIV-1 (immunology), Herpes Genitalis (complications), Herpes Genitalis (drug therapy), Herpes Genitalis (virology), Humans, Male, RNA, Viral (metabolism), Ulcer (complications), Ulcer (drug therapy), Ulcer (virology), Young Adult.
- MESH :
- chemical , metabolism : RNA, Viral.
- chemical , therapeutic use : Acyclovir.
- geographic : Africa South of the Sahara.
- complications : HIV Seropositivity, Herpes Genitalis, Ulcer.
- drug effects : HIV-1.
- drug therapy : Herpes Genitalis, Ulcer.
- immunology : HIV-1.
- virology : Herpes Genitalis, Ulcer.
- Adolescent, Adult, Female, Humans, Male, Young Adult.
Abstract
A randomized controlled trial in South Africa found a beneficial effect of acyclovir on genital ulcer healing, but no effect was seen in trials in Ghana, Central African Republic and Malawi. The aim of this paper is to assess whether the variation in impact of acyclovir on ulcer healing in these trials can be explained by differences in the characteristics of the study populations.
DOI: 10.1371/journal.pone.0022601
PubMed: 21799914
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Episodic therapy for genital herpes in sub-saharan Africa: a pooled analysis from three randomized controlled trials.</title><author><name sortKey="Weiss, Helen A" sort="Weiss, Helen A" uniqKey="Weiss H" first="Helen A" last="Weiss">Helen A. Weiss</name><affiliation><nlm:affiliation>London School of Hygiene and Tropical Medicine, London, United Kingdom. helen.weiss@lshtm.ac.uk</nlm:affiliation></affiliation></author><author><name sortKey="Paz Bailey, Gabriela" sort="Paz Bailey, Gabriela" uniqKey="Paz Bailey G" first="Gabriela" last="Paz Bailey">Gabriela Paz Bailey</name></author><author><name sortKey="Phiri, Sam" sort="Phiri, Sam" uniqKey="Phiri S" first="Sam" last="Phiri">Sam Phiri</name></author><author><name sortKey="Gresenguet, Gerard" sort="Gresenguet, Gerard" uniqKey="Gresenguet G" first="Gerard" last="Gresenguet">Gerard Gresenguet</name></author><author><name sortKey="Legoff, Jerome" sort="Legoff, Jerome" uniqKey="Legoff J" first="Jerome" last="Legoff">Jerome Legoff</name></author><author><name sortKey="Pepin, Jacques" sort="Pepin, Jacques" uniqKey="Pepin J" first="Jacques" last="Pepin">Jacques Pepin</name></author><author><name sortKey="Lewis, David A" sort="Lewis, David A" uniqKey="Lewis D" first="David A" last="Lewis">David A. Lewis</name></author><author><name sortKey="Belec, Laurent" sort="Belec, Laurent" uniqKey="Belec L" first="Laurent" last="Belec">Laurent Belec</name></author><author><name sortKey="Hoffman, Irving F" sort="Hoffman, Irving F" uniqKey="Hoffman I" first="Irving F" last="Hoffman">Irving F. Hoffman</name></author><author><name sortKey="Miller, William C" sort="Miller, William C" uniqKey="Miller W" first="William C" last="Miller">William C. Miller</name></author><author><name sortKey="Mayaud, Philippe" sort="Mayaud, Philippe" uniqKey="Mayaud P" first="Philippe" last="Mayaud">Philippe Mayaud</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2011">2011</date><idno type="RBID">pubmed:21799914</idno><idno type="pmid">21799914</idno><idno type="doi">10.1371/journal.pone.0022601</idno><idno type="wicri:Area/PubMed/Corpus">000672</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000672</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Episodic therapy for genital herpes in sub-saharan Africa: a pooled analysis from three randomized controlled trials.</title><author><name sortKey="Weiss, Helen A" sort="Weiss, Helen A" uniqKey="Weiss H" first="Helen A" last="Weiss">Helen A. Weiss</name><affiliation><nlm:affiliation>London School of Hygiene and Tropical Medicine, London, United Kingdom. helen.weiss@lshtm.ac.uk</nlm:affiliation></affiliation></author><author><name sortKey="Paz Bailey, Gabriela" sort="Paz Bailey, Gabriela" uniqKey="Paz Bailey G" first="Gabriela" last="Paz Bailey">Gabriela Paz Bailey</name></author><author><name sortKey="Phiri, Sam" sort="Phiri, Sam" uniqKey="Phiri S" first="Sam" last="Phiri">Sam Phiri</name></author><author><name sortKey="Gresenguet, Gerard" sort="Gresenguet, Gerard" uniqKey="Gresenguet G" first="Gerard" last="Gresenguet">Gerard Gresenguet</name></author><author><name sortKey="Legoff, Jerome" sort="Legoff, Jerome" uniqKey="Legoff J" first="Jerome" last="Legoff">Jerome Legoff</name></author><author><name sortKey="Pepin, Jacques" sort="Pepin, Jacques" uniqKey="Pepin J" first="Jacques" last="Pepin">Jacques Pepin</name></author><author><name sortKey="Lewis, David A" sort="Lewis, David A" uniqKey="Lewis D" first="David A" last="Lewis">David A. Lewis</name></author><author><name sortKey="Belec, Laurent" sort="Belec, Laurent" uniqKey="Belec L" first="Laurent" last="Belec">Laurent Belec</name></author><author><name sortKey="Hoffman, Irving F" sort="Hoffman, Irving F" uniqKey="Hoffman I" first="Irving F" last="Hoffman">Irving F. Hoffman</name></author><author><name sortKey="Miller, William C" sort="Miller, William C" uniqKey="Miller W" first="William C" last="Miller">William C. Miller</name></author><author><name sortKey="Mayaud, Philippe" sort="Mayaud, Philippe" uniqKey="Mayaud P" first="Philippe" last="Mayaud">Philippe Mayaud</name></author></analytic><series><title level="j">PloS one</title><idno type="eISSN">1932-6203</idno><imprint><date when="2011" type="published">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Acyclovir (therapeutic use)</term><term>Adolescent</term><term>Adult</term><term>Africa South of the Sahara</term><term>Female</term><term>HIV Seropositivity (complications)</term><term>HIV-1 (drug effects)</term><term>HIV-1 (immunology)</term><term>Herpes Genitalis (complications)</term><term>Herpes Genitalis (drug therapy)</term><term>Herpes Genitalis (virology)</term><term>Humans</term><term>Male</term><term>RNA, Viral (metabolism)</term><term>Ulcer (complications)</term><term>Ulcer (drug therapy)</term><term>Ulcer (virology)</term><term>Young Adult</term></keywords><keywords scheme="MESH" type="chemical" qualifier="metabolism" xml:lang="en"><term>RNA, Viral</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Acyclovir</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Africa South of the Sahara</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>HIV Seropositivity</term><term>Herpes Genitalis</term><term>Ulcer</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>HIV-1</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Herpes Genitalis</term><term>Ulcer</term></keywords><keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>HIV-1</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Herpes Genitalis</term><term>Ulcer</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Female</term><term>Humans</term><term>Male</term><term>Young Adult</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">A randomized controlled trial in South Africa found a beneficial effect of acyclovir on genital ulcer healing, but no effect was seen in trials in Ghana, Central African Republic and Malawi. The aim of this paper is to assess whether the variation in impact of acyclovir on ulcer healing in these trials can be explained by differences in the characteristics of the study populations.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">21799914</PMID><DateCreated><Year>2011</Year><Month>07</Month><Day>29</Day></DateCreated><DateCompleted><Year>2011</Year><Month>12</Month><Day>06</Day></DateCompleted><DateRevised><Year>2017</Year><Month>09</Month><Day>02</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1932-6203</ISSN><JournalIssue CitedMedium="Internet"><Volume>6</Volume><Issue>7</Issue><PubDate><Year>2011</Year></PubDate></JournalIssue><Title>PloS one</Title><ISOAbbreviation>PLoS ONE</ISOAbbreviation></Journal><ArticleTitle>Episodic therapy for genital herpes in sub-saharan Africa: a pooled analysis from three randomized controlled trials.</ArticleTitle><Pagination><MedlinePgn>e22601</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1371/journal.pone.0022601</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">A randomized controlled trial in South Africa found a beneficial effect of acyclovir on genital ulcer healing, but no effect was seen in trials in Ghana, Central African Republic and Malawi. The aim of this paper is to assess whether the variation in impact of acyclovir on ulcer healing in these trials can be explained by differences in the characteristics of the study populations.</AbstractText><AbstractText Label="METHODOLOGY/PRINCIPAL FINDINGS" NlmCategory="RESULTS">Pooled data were analysed to estimate the impact of acyclovir on the proportion of ulcers healed seven days after randomisation by HIV/CD4 status, ulcer aetiology, size and duration before presentation; and impact on lesional HIV-1. Risk ratios (RR) were estimated using Poisson regression with robust standard errors. Of 1478 patients with genital ulcer, most (63%) had herpetic ulcers (16% first episode HSV-2 ulcers), and a further 3% chancroid, 2% syphilis, 0.7% lymphogranuloma venereum and 31% undetermined aetiology. Over half (58%) of patients were HIV-1 seropositive. The median duration of symptoms before presentation was 6 days. Patients on acyclovir were more likely to have a healed ulcer on day 7 (63% vs 57%, RR = 1.08, 95% CI 0.98-1.18), shorter time to healing (p = 0.04) and less lesional HIV-1 RNA (p = 0.03). Small ulcers (<50 mm(2)), HSV-2 ulcers, first episode HSV-2 ulcers, and ulcers in HIV-1 seropositive individuals responded best but the better effectiveness in South Africa was not explained by differences in these factors.</AbstractText><AbstractText Label="CONCLUSIONS/SIGNIFICANCE" NlmCategory="CONCLUSIONS">There may be slight benefit in adding acyclovir to syndromic management in settings where most ulcers are genital herpes. The stronger effect among HIV-1 infected individuals suggests that acyclovir may be beneficial for GUD/HIV-1 co-infected patients. The high prevalence in this population highlights that genital ulceration in patients with unknown HIV status provides a potential entry point for provider-initiated HIV testing.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Weiss</LastName><ForeName>Helen A</ForeName><Initials>HA</Initials><AffiliationInfo><Affiliation>London School of Hygiene and Tropical Medicine, London, United Kingdom. helen.weiss@lshtm.ac.uk</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Paz Bailey</LastName><ForeName>Gabriela</ForeName><Initials>G</Initials></Author><Author ValidYN="Y"><LastName>Phiri</LastName><ForeName>Sam</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Gresenguet</LastName><ForeName>Gerard</ForeName><Initials>G</Initials></Author><Author ValidYN="Y"><LastName>LeGoff</LastName><ForeName>Jerome</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Pepin</LastName><ForeName>Jacques</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Lewis</LastName><ForeName>David A</ForeName><Initials>DA</Initials></Author><Author ValidYN="Y"><LastName>Belec</LastName><ForeName>Laurent</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Hoffman</LastName><ForeName>Irving F</ForeName><Initials>IF</Initials></Author><Author ValidYN="Y"><LastName>Miller</LastName><ForeName>William C</ForeName><Initials>WC</Initials></Author><Author ValidYN="Y"><LastName>Mayaud</LastName><ForeName>Philippe</ForeName><Initials>P</Initials></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>MRC_G0700837</GrantID><Agency>Medical Research Council</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>U62/CCU022901</GrantID><Agency>PHS HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016449">Randomized Controlled Trial</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType><PublicationType UI="D013487">Research Support, U.S. Gov't, P.H.S.</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2011</Year><Month>07</Month><Day>25</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>PLoS One</MedlineTA><NlmUniqueID>101285081</NlmUniqueID><ISSNLinking>1932-6203</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D012367">RNA, Viral</NameOfSubstance></Chemical><Chemical><RegistryNumber>X4HES1O11F</RegistryNumber><NameOfSubstance UI="D000212">Acyclovir</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Am J Epidemiol. 2004 Apr 1;159(7):702-6</RefSource><PMID 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MajorTopicYN="N">Acyclovir</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017954" MajorTopicYN="N" Type="Geographic">Africa South of the Sahara</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006679" MajorTopicYN="N">HIV Seropositivity</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015497" MajorTopicYN="N">HIV-1</DescriptorName><QualifierName UI="Q000187" MajorTopicYN="N">drug effects</QualifierName><QualifierName UI="Q000276" 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