Herpes simplex virus (HSV) suppression with valacyclovir reduces rectal and blood plasma HIV-e1 levels in HIV-1/HSV-2-Seropositive men:: A randomized, double-blind, placebo-controlled crossover trial
Herpes simplex virus (HSV) suppression with valacyclovir reduces rectal and blood plasma HIV-e1 levels in HIV-1/HSV-2-Seropositive men:: A randomized, double-blind, placebo-controlled crossover trial
复制标题
DOI：
10.1086/522523
复制
发表时间：
2007-11-15
影响因子：
6.4
通讯作者：
Celum, Connie
中科院分区：
文献类型：
--
作者：
Zuckerman, Richard A.;Lucchetti, Aldo;Celum, Connie
背景资料。单纯疱疹病毒2型(HSV-2)感染在人类免疫缺陷病毒(HIV)感染者中很常见，HSV重新激活会增加血浆和生殖器中HIV-1的水平。我们在安慰剂对照交叉试验中研究了单纯疱疹病毒联合感染者抑制过程中的HIV-1水平。在秘鲁利马，20名HIV-1/HSV-2血清阳性、CD4细胞计数为200个/亩的男男性行为者被随机分为两组，分别接受万乃洛韦500 mg每日2次或安慰剂治疗8周，之后他们接受为期2周的洗涤期，然后接受替代治疗8周。样本包括每日肛门生殖器拭子(用于HSV DNA聚合酶链式反应)、每周三次直肠粘膜分泌物(用于HIV-1RNA和HSVDNAPCR)和每周血浆(用于HIV-1RNA聚合酶链式反应)。结果：治疗组的直肠和血浆中HIV-1RNA水平。844例直肠标本和288例血浆标本中，HIV-1阳性率分别为73%和99%。在服用安慰剂和万乃洛韦的皮肤粘膜标本中，HSV的检出率分别为29%和4%(P
Background. Herpes simplex virus type 2 (HSV-2) infection is common among human immunodeficiency virus (HIV)-infected persons, and HSV reactivation increases plasma and genital HIV-1 levels. We studied HIV-1 levels during HSV suppression in coinfected persons in a placebo-controlled crossover trial.Methods. Twenty antiretroviral therapy (ART)-naive HIV-1/ HSV-2-seropositive men who have sex with men in Lima, Peru, with CD4 cell counts > 200 cells/mu L were randomized to receive either valacyclovir at 500 mg twice daily or placebo for 8 weeks, after which they underwent a 2-week washout period and then received the alternative regimen for 8 weeks. Specimens included daily anogenital swabs (for HSV DNA polymerase chain reaction [PCR]), thrice weekly rectal mucosal secretions (for HIV-1 RNA and HSVDNAPCR) obtained by anoscopy, and weekly plasma (for HIV-1 RNA PCR). Outcomes were rectal and plasma HIV-1 RNA levels by treatment arm.Results. HIV-1 was detected in 73% of 844 rectal and 99% of 288 plasma specimens. HSV was detected in 29% and 4% of mucocutaneous specimens obtained during placebo and valacyclovir administration, respectively (P