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Title: Characteristics of HIV-1 discordant couples enrolled in a trial of HSV-2 suppression to reduce HIV-1 transmission: the partners study
Authors: Lingappa, Jairam R.
Kahle, Erin
Mugo, Nelly
Mujugira, Andrew
Magaret, Amalia
Baeten, Jared
Bukusi, Elizabeth A.
Cohen, Craig R.
Katabira, Elly
Ronald, Allan
Kiarie, James
Farquhar, Carey
Stewart, Grace John
Makhema, Joseph
Were, Edwin
Keywords: Discordant couples
HSV-2 suppression
HIV-1 transmission
Issue Date: 2009
Publisher: Public Library of Science
Abstract: Background:The Partners HSV-2/HIV-1 Transmission Study (Partners Study) is a phase III, placebo-controlled trial of daily acyclovir for genital herpes (HSV-2) suppression among HIV-1/HSV-2 co-infected persons to reduce HIV-1 transmission to their HIV-1 susceptible partners, which requires recruitment of HIV-1 serodiscordant heterosexual couples. We describe the baseline characteristics of this cohort.Methods:HIV-1 serodiscordant heterosexual couples, in which the HIV-1 infected partner was HSV-2 seropositive, had a CD4count$250 cells/mcL and was not on antiretroviral therapy, were enrolled at 14 sites in East and Southern Africa.Demographic, behavioral, clinical and laboratory characteristics were assessed.Results:Of the 3408 HIV-1 serodiscordant couples enrolled, 67% of the HIV-1 infected partners were women. Couples had cohabitated for a median of 5 years (range 2–9) with 28% reporting unprotected sex in the month prior to enrollment.Among HIV-1 susceptible participants, 86% of women and 59% of men were HSV-2 seropositive. Other laboratory-diagnosed sexually transmitted infections were uncommon (,5%), except for Trichomonas vaginalisin 14% of HIV-1infected women. Median baseline CD4 count for HIV-1 infected participants was 462cells/mcL and median HIV-1 plasma RNA was 4.2 log10copies/mL. After adjusting for age and African region, correlates of HIV-1 RNA level included male gender(+0.24 log10copies/mL; p,0.001) and CD4 count (20.25 and20.55 log10copies/mL for CD4 350–499 and.500 relative to,350, respectively, p,0.001).Conclusions:The Partners Study successfully enrolled a cohort of 3408 heterosexual HIV-1 serodiscordant couples in Africaat high risk for HIV-1 transmission. Follow-up of this cohort will evaluate the efficacy of acyclovir for HSV-2 suppression in preventing HIV-1 transmission and provide insights into biological and behavioral factors determining heterosexual HIV-1transmission. Trial Registration:Clinical NCT00194519
Appears in Collections:School of Medicine

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