No impact of oral tenofovir disoproxil fumarate on herpes simplex virus shedding in HIV-infected adults
No impact of oral tenofovir disoproxil fumarate on herpes simplex virus shedding in HIV-infected adults
复制标题
DOI：
10.1097/qad.0b013e328341ddf7
复制
发表时间：
2011-01-01
期刊：
影响因子：
3.8
通讯作者：
Walmsley, Sharon L.
中科院分区：
文献类型：
--
作者：
Tan, Darrell H. S.;Kaul, Rupert;Walmsley, Sharon L.
目的：确定口服替诺福韦联合抗逆转录病毒治疗对无症状单纯疱疹病毒(HSV)脱落的影响。设计：对HSV和HIV-1混合感染的成人队列进行观察性研究。方法：采用类型特异性血清学(HerpeSelect ELISA，Focus Technologies)诊断HSV感染。无症状的单纯疱疹病毒、艾滋病毒-1混合感染者，在抗逆转录病毒治疗中艾滋病毒病毒载量低于50拷贝/毫升，每天收集口腔、生殖器和肛门拭子，持续28天。冷藏标本每周取一次，用聚合酶链式反应(PCR)检测HSV-1和HSV-2。结果：共纳入40例混合感染患者，其中30例HSV-2血清阳性。替诺福韦是40名参与者中22名(55%)和30名HSV-2感染者中17名(57%)抗逆转录病毒方案的一部分。HSV-2阳性患者中HSV-2的中位数(四分位数范围)脱落率较低，仅占标本采集天数的7.1%(0，14.3)，而替诺福韦使用者和非使用者之间无差异(P=0.36)。替诺福韦组和非替诺福韦组的HSV-2脱落率分别为59%和46%，差异无统计学意义(P=0.49)。在替诺福韦使用者和非使用者之间，单纯使用HSV-1(P=0.59)，以及HSV-1或HSV-2(P=0.38)的脱落率也是相似的。结论：尽管在最近的CAPRISA 004试验中，外用1%替诺福韦凝胶与高危女性的HSV-2感染显著减少有关，在这些初步数据中，我们没有观察到口服替诺福韦对HIV和HSV合并感染的无症状成年人中HSV-2或HSV-1脱落率的影响。(C)2011年Wolters Kluwer Health垂直酒吧Lippincott Williams&Wilkins
Objective: To determine the impact of oral tenofovir as part of combination antiretroviral therapy on asymptomatic herpes simplex virus (HSV) shedding.Design: Observational study of a cohort of HSV, HIV-1 co-infected adults.Methods: HSV infection was diagnosed using type-specific serology (HerpeSelect ELISA, Focus Technologies). Asymptomatic HSV, HIV-1 co-infected individuals achieving HIV viral load below 50 copies/ml on antiretroviral therapy self-collected oral, genital and anal swabs daily for 28 days. Refrigerated specimens were dropped off weekly for HSV-1 and HSV-2 testing by polymerase chain reaction (PCR). Shedding rate was calculated as the proportion of days on which HSV PCR was positive.Results: Forty co-infected patients were enrolled, of whom 30 were HSV-2 seropositive. Tenofovir was part of the antiretroviral regimen in 22 of 40 (55%) participants overall and 17 of 30 (57%) of HSV-2 infected participants. The median (interquartile range) HSV-2 shedding rate among HSV-2 seropositive participants was low, at 7.1% (0, 14.3) of specimen collection days, and did not differ between tenofovir users and nonusers (P = 0.36). There was no difference in the number of HSV-2 shedders in the tenofovir and nontenofovir groups (59 vs. 46%; P = 0.49). Rates of shedding for HSV-1 alone (P = 0.59), and for either HSV-1 or HSV-2 (P = 0.38), were also similar between tenofovir users and nonusers.Conclusion: Although topical tenofovir 1% gel was associated with a significant decrease in HSV-2 acquisition among high-risk women in the recent CAPRISA 004 trial, in these preliminary data we did not observe an impact of oral tenofovir on HSV-2 or HSV-1 shedding rates among HIV, HSV co-infected asymptomatic adults. (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins