BACKGROUND:Nucleoside analoguesagainst herpes simplex virus (HSV) have been shown to suppress shedding of HSV type 2 (HSV-2) on genital mucosal surfaces and may prevent sexual transmission of HSV. METHODS: We followed 1484 immunocompetent, heterosexual, monogamous couples: one with clinically symptomatic genital HSV-2 and one susceptible to HSV-2. The partners with HSV-2 infection were randomly assigned to receive either 500 mg of valacyclovir once daily or placebo for eight months. The susceptible partner was evaluated monthly for clinical signs and symptoms of genital herpes. Source partners were followed for recurrences of genital herpes; 89 were enrolled in a substudy of HSV-2 mucosal shedding. Both partners were counseled on safer sex and were offered condoms at each visit. The predefined primary end point was the reduction in transmission of symptomatic genital herpes. RESULTS:Clinically symptomatic HSV-2 infection developed in 4 of 743 susceptible partners who were given valacyclovir, as compared with 16 of 741 who were given placebo (hazard ratio, 0.25; 95 percent confidence interval, 0.08 to 0.75; P=0.008). Overall, acquisition of HSV-2 was observed in 14 of the susceptible partners who received valacyclovir (1.9 percent), as compared with 27 (3.6 percent) who received placebo (hazard ratio, 0.52; 95 percent confidence interval, 0.27 to 0.99; P=0.04). HSV DNA was detected in samples of genital secretions on 2.9 percent of the days among the HSV-2-infected (source) partners who received valacyclovir, as compared with 10.8 percent of the days among those who received placebo (P<0.001). The mean rates of recurrence were 0.11 per month and 0.40 per month, respectively (P<0.001). CONCLUSIONS: Once-daily suppressive therapy with valacyclovir significantly reduces the risk of transmission of genital herpes among heterosexual, HSV-2-discordant couples. Copyright 2004 Massachusetts Medical Society
RCT Entities:
BACKGROUND:Nucleoside analogues against herpes simplex virus (HSV) have been shown to suppress shedding of HSV type 2 (HSV-2) on genital mucosal surfaces and may prevent sexual transmission of HSV. METHODS: We followed 1484 immunocompetent, heterosexual, monogamous couples: one with clinically symptomatic genital HSV-2 and one susceptible to HSV-2. The partners with HSV-2 infection were randomly assigned to receive either 500 mg of valacyclovir once daily or placebo for eight months. The susceptible partner was evaluated monthly for clinical signs and symptoms of genital herpes. Source partners were followed for recurrences of genital herpes; 89 were enrolled in a substudy of HSV-2 mucosal shedding. Both partners were counseled on safer sex and were offered condoms at each visit. The predefined primary end point was the reduction in transmission of symptomatic genital herpes. RESULTS: Clinically symptomatic HSV-2 infection developed in 4 of 743 susceptible partners who were given valacyclovir, as compared with 16 of 741 who were given placebo (hazard ratio, 0.25; 95 percent confidence interval, 0.08 to 0.75; P=0.008). Overall, acquisition of HSV-2 was observed in 14 of the susceptible partners who received valacyclovir (1.9 percent), as compared with 27 (3.6 percent) who received placebo (hazard ratio, 0.52; 95 percent confidence interval, 0.27 to 0.99; P=0.04). HSV DNA was detected in samples of genital secretions on 2.9 percent of the days among the HSV-2-infected (source) partners who received valacyclovir, as compared with 10.8 percent of the days among those who received placebo (P<0.001). The mean rates of recurrence were 0.11 per month and 0.40 per month, respectively (P<0.001). CONCLUSIONS: Once-daily suppressive therapy with valacyclovir significantly reduces the risk of transmission of genital herpes among heterosexual, HSV-2-discordant couples. Copyright 2004 Massachusetts Medical Society
Authors: Enrique R Pouget; Trace S Kershaw; Kim M Blankenship; Jeannette R Ickovics; Linda M Niccolai Journal: Sex Transm Dis Date: 2010-09 Impact factor: 2.830
Authors: Sita Awasthi; John W Balliet; Jessica A Flynn; John M Lubinski; Carolyn E Shaw; Daniel J DiStefano; Michael Cai; Martha Brown; Judith F Smith; Rose Kowalski; Ryan Swoyer; Jennifer Galli; Victoria Copeland; Sandra Rios; Robert C Davidson; Maya Salnikova; Susan Kingsley; Janine Bryan; Danilo R Casimiro; Harvey M Friedman Journal: J Virol Date: 2013-11-27 Impact factor: 5.103
Authors: S L Rosenthal; G D Zimet; J S Leichliter; L R Stanberry; K H Fife; W Tu; D I Bernstein Journal: Sex Transm Infect Date: 2006-04 Impact factor: 3.519
Authors: Alexis M Roth; Barbara Van Der Pol; J Dennis Fortenberry; Brian Dodge; Michael Reece; David Certo; Gregory D Zimet Journal: J Health Commun Date: 2014-12-12
Authors: J L Meyer; R A Crosby; W L H Whittington; D Carrell; R Ashley-Morrow; A S Meier; R D Harrington; R DiClemente; A Wald Journal: Sex Transm Infect Date: 2005-08 Impact factor: 3.519
Authors: Gail F Shust; Sylvia Cho; Mimi Kim; Rebecca P Madan; Esmeralda M Guzman; Margaret Pollack; Julia Epstein; Hillel W Cohen; Marla J Keller; Betsy C Herold Journal: Am J Reprod Immunol Date: 2009-12-15 Impact factor: 3.886