Tanton C., Weiss H.A., LeGoff J., Changalucha J., Clayton T.C., Ross D.A., Belec L., Hayes R.J., Watson-Jones D.
London School of Hygiene and Tropical Medicine, London, United Kingdom; National Institute for Medical Research (NIMR), Mwanza, Tanzania; Laboratoire de Microbiologie, Hôpital Saint Louis, Paris, France; Départment de Microbiologie, Hôpital Européen Georges Pompidou, Université Paris Descartes, Paris, France; African Medical and Research Foundation (AMREF), Mwanza, Tanzania
Tanton, C., London School of Hygiene and Tropical Medicine, London, United Kingdom, National Institute for Medical Research (NIMR), Mwanza, Tanzania; Weiss, H.A., London School of Hygiene and Tropical Medicine, London, United Kingdom; LeGoff, J., Laboratoire de Microbiologie, Hôpital Saint Louis, Paris, France; Changalucha, J., National Institute for Medical Research (NIMR), Mwanza, Tanzania; Clayton, T.C., London School of Hygiene and Tropical Medicine, London, United Kingdom; Ross, D.A., London School of Hygiene and Tropical Medicine, London, United Kingdom; Belec, L., Départment de Microbiologie, Hôpital Européen Georges Pompidou, Université Paris Descartes, Paris, France; Hayes, R.J., London School of Hygiene and Tropical Medicine, London, United Kingdom; Watson-Jones, D., London School of Hygiene and Tropical Medicine, London, United Kingdom, African Medical and Research Foundation (AMREF), Mwanza, Tanzania
Objectives: Few studies have examined the frequency and duration of genital herpes simplex virus (HSV) shedding in sub-Saharan Africa. This study describes HSV shedding patterns among a sample of HSV-2-seropositive women enrolled in a placebo-controlled trial of HSV suppressive therapy (acyclovir 400 mg twice a day) in Tanzania. Methods: Trial participants were invited to participate in a substudy involving 12 clinic visits over 4 weeks. At each visit, cervical, vaginal and external skin swabs were taken and analysed for HSV DNA using inhouse real-time PCR. Results: HSV shedding was mainly subclinical (90%; 57/63 shedding days in the placebo arm). The most frequent shedding site was the external skin, but HSV DNA was detected from all three sites on 42% (27/63) of shedding days. In HIV-negative women, HSV DNA was detected on 3% (9/275) of days in the acyclovir versus 11% (33/309) in the placebo arm, while in HIV-positive women, detection was on 14% (23/160) versus 19% (30/155) of days, respectively. Conclusions: HSV shedding was common, varying greatly by individual. Shedding rates were similar to studies in African and non-African settings. Among HIVnegative women, shedding rates were lower in the acyclovir arm; however, acyclovir did not substantially impact on HSV shedding in HIV-positive women.
aciclovir; placebo; adult; article; controlled study; female; follow up; Herpes simplex virus; human; Human immunodeficiency virus 2 infection; Human immunodeficiency virus infection; immunosuppressive treatment; major clinical study; nonhuman; priority journal; randomized controlled trial; real time polymerase chain reaction; Tanzania; virus detection; virus shedding; Acyclovir; Adult; Antiviral Agents; DNA, Viral; Female; Herpes Genitalis; Herpesvirus 2, Human; HIV Seronegativity; HIV Seropositivity; HIV-1; Humans; Tanzania; Time Factors; Virus Shedding