Suppressive acyclovir therapy reduces HIV cervicovaginal shedding in HIV- and HSV-2-infected women, Chiang Rai, Thailand
Suppressive acyclovir therapy reduces HIV cervicovaginal shedding in HIV- and HSV-2-infected women, Chiang Rai, Thailand
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DOI：
10.1097/qai.0b013e3181831832
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发表时间：
2008-09-01
影响因子：
3.6
通讯作者：
Markowitz, Lauri
中科院分区：
文献类型：
--
作者：
Dunne, Eileen F.;Whitehead, Sara;Markowitz, Lauri
背景：单纯疱疹病毒2型感染很重要，是HIV的流行，并可能导致HIV传播的增加。方法：选择18~49岁、CD_4细胞计数200个/亩的HIV-1和单纯疱疹病毒2型混合感染的女性L作为研究对象，采用随机交叉试验方法(NCT00362596，http://www.clinicaltrials.gov).)进行研究。每名妇女每月采集血浆和每周宫颈阴道灌洗液标本，比较每月宫颈阴道灌洗液中HIV I病毒载量和血浆HIV-1病毒载量的平均值。结果：在基线水平，CD_4细胞数中位数为366个/亩L，HIV-1血浆病毒载量中位数为4.6log(10)拷贝/毫升。在服用阿昔洛韦的患者中，宫颈阴道灌洗液中的HIV-1病毒载量平均为1.9log(SD0.8)拷贝/毫升，在服用安慰剂的患者中，平均为2.2log(SD0.7)拷贝/毫升(P<；0.0001)；艾滋病毒的平均下降为0.3log(10)拷贝/毫升。服用阿昔洛韦月份的平均血浆HIV病毒载量(3.78个对数(10)拷贝/毫升)低于安慰剂月份(4.26个对数(10)拷贝/毫升)。P<；0.001)。结论：在HIV-1和单纯疱疹病毒2型混合感染的妇女中，阿昔洛韦减少了艾滋病毒生殖器脱落和血浆病毒载量。来自临床试验的进一步数据将检验抑制疗法对艾滋病毒传播的影响。
Background: Herpes simplex virus type 2 infection is important is the HIV epidemic and may contribute to increased HIV transmission. We evaluated the effect Of Suppressive acyclovir therapy oil cervicovaginal HIV-1 shedding.Methods: HIV-1- and herpes simplex virus type 2-coinfected women aged 18-49 years with CD4 counts >200 cells/mu L were enrolled in a randomized crossover trial Of Suppressive acyclovir therapy (NCT00362596, http://www.clinicaltrials.gov). For each woman, monthly plasma and weekly cervicovaginal lavage specimens were collected; the mean of the monthly median cervicovaginal lavage HIV I viral load and plasma HIV-1 viral load was compared.Results: Sixty-seven women were enrolled; at baseline, median CD4 count was 366 cells/mu L, and median HIV-1 plasma viral load was 4.6 log(10) copies/mL. The mean cervicovaginal lavage HIV-1 viral load was 1.9 (SD 0.8) log(10) copies/mL during the acyclovir month and 2.2 (SD 0.7) log(10) copies/mL during the placebo month (P < 0.0001); the mean decrease in HIV was 0.3 log(10) copies/mL. The mean plasma HIV viral load during the acyclovir month (3.78 log(10) copies/mL) was reduced compared with the placebo month (4.26 log(10) copies/mL. P < 0.001).Conclusions: Acyclovir reduced HIV genital shedding and plasma viral load among HIV-1- and herpes simplex virus type 2-coinfected women. Further data from clinical trials will examine the effect of suppressive therapy on HIV transmission.