[HTML][HTML] Characteristics of HIV-1 discordant couples enrolled in a trial of HSV-2 suppression to reduce HIV-1 transmission: the partners study

JR Lingappa, E Kahle, N Mugo, A Mujugira, A Magaret… - PloS one, 2009 - journals.plos.org
JR Lingappa, E Kahle, N Mugo, A Mujugira, A Magaret, J Baeten, EA Bukusi, CR Cohen
PloS one, 2009journals.plos.org
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 …
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 CD4 count ≥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 vaginalis in 14% of HIV-1 infected women. Median baseline CD4 count for HIV-1 infected participants was 462cells/mcL and median HIV-1 plasma RNA was 4.2 log10 copies/mL. After adjusting for age and African region, correlates of HIV-1 RNA level included male gender (+0.24 log10 copies/mL; p<0.001) and CD4 count (−0.25 and −0.55 log10 copies/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 Africa at 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-1 transmission.
Trial Registration
ClinicalTrials.gov NCT00194519
PLOS
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