{"id":2214,"date":"2007-09-03T14:34:18","date_gmt":"2007-09-03T13:34:18","guid":{"rendered":"http:\/\/moomango.co.uk\/htb\/?p=2214"},"modified":"2013-09-12T16:58:45","modified_gmt":"2013-09-12T16:58:45","slug":"no-impact-of-hsv-2-suppressive-therapy-on-hiv-incidence","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/2214","title":{"rendered":"No impact of HSV-2 suppressive therapy on HIV incidence"},"content":{"rendered":"<p><strong>Polly Clayden, HIV i-Base<\/strong><\/p>\n<p><strong>Deborah Watson-Jones, from the London School of Hygiene &amp; Tropical Medicine presented data from a study to evaluate the impact of suppressive HSV-2 treatment on HIV incidence among women at high risk of infection in northern Tanzania.<\/strong><\/p>\n<p>Acyclovir has been shown in recent studies to reduce genital shedding of HIV in women co-infected with HIV and HSV-2.<\/p>\n<p>This was a randomised, double-blind, placebo-controlled trial of acyclovir (400 mg BD) among initially HIV-negative\/HSV-2 positive women. Women working in bars, guesthouses and similar facilities attending mobile clinics were followed for a maximum of 30 months.<\/p>\n<p>Clinic visits were every 3 months women received safe sex counseling, condoms, routine health checks, STI treatment and were offered VCT.<\/p>\n<p>821 HIV-seronegative women were enrolled in three phases and randomised to acyclovir (n=400) or placebo (n=421). 216 (26%) withdrew from study tablets, mainly because of pregnancy (79%).<\/p>\n<p>Dr Watson Jones reported that in an intent-to-treat analysis: 316 (75%) and 280 (70%) of women completed follow-up (FU) &#8211; with 72 (17%) and 90 (23%) lost &#8211; in the placebo and acyclovir arms respectively. There were 33 (8%) seroconversions in the placebo arm and 30 (80%) in the acyclovir arm. This gave 777 and 699 person years of FU and an HIV incidence rate\/100 person years of 4.25 (3.6-6.0) and 4.29(3.00-6.1), rate ratio1.01 (0.61-1.66), in the placebo and acyclovir arms.<\/p>\n<p>The investigators suggested that these disappointing results could be associated with poor adherence; in on-treatment analysis by adherence they reported a rate ratio of 0.58 (0.3-1.4) of &gt;\/= 90% adherence.<\/p>\n<p>They concluded that there was \u0093No effect of acyclovir on HIV incidence\u0094 but proof of concept may require a higher level of adherence.<\/p>\n<p class=\"ref\">Reference:<\/p>\n<p class=\"ref\">Watson-Jones D, Rusizoka M, Weiss H et al. Impact of HSV-2 suppressive therapy on HIV incidence in HSV-2 seropositive women: a randomised controlled trial in Tanzania. 4th IAS conference, Sydney, 2007. Oral abstract MOAC104.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Polly Clayden, HIV i-Base Deborah Watson-Jones, from the London School of Hygiene &amp; Tropical Medicine presented data from a study to evaluate the impact of suppressive HSV-2 treatment on HIV incidence among women at high risk of infection in northern &hellip;<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[92],"class_list":["post-2214","post","type-post","status-publish","format-standard","hentry","category-conference-reports","tag-ias-4th-2007"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/2214","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=2214"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/2214\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=2214"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=2214"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=2214"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}