Acyclovir Prophylaxis Reduces the Incidence of Herpes Zoster Among HIV-Infected Individuals: Results of a Randomized Clinical Trial

Ruanne V Barnabas; Jared M Baeten; Jairam R Lingappa; Katherine K Thomas; James P Hughes; Nelly R Mugo; Sinead Delany-Moretlwe; Glenda Gray; Helen Rees; Andrew Mujugira; Allan Ronald; Wendy Stevens; Saidi Kapiga; Anna Wald; Connie Celum; Partners in Prevention HSV/HIV Transmission Study Team

doi:10.1093/infdis/jiv318

Acyclovir Prophylaxis Reduces the Incidence of Herpes Zoster Among HIV-Infected Individuals: Results of a Randomized Clinical Trial

J Infect Dis. 2016 Feb 15;213(4):551-5. doi: 10.1093/infdis/jiv318. Epub 2015 Jun 8.

Authors

Ruanne V Barnabas¹, Jared M Baeten², Jairam R Lingappa³, Katherine K Thomas⁴, James P Hughes⁵, Nelly R Mugo⁴, Sinead Delany-Moretlwe⁶, Glenda Gray⁷, Helen Rees⁶, Andrew Mujugira⁸, Allan Ronald⁹, Wendy Stevens¹⁰, Saidi Kapiga¹¹, Anna Wald¹², Connie Celum²; Partners in Prevention HSV/HIV Transmission Study Team

Affiliations

¹ Department of Global Health, University of Washington Department of Medicine, University of Washington Department of Epidemiology, University of Washington Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
² Department of Global Health, University of Washington Department of Medicine, University of Washington Department of Epidemiology, University of Washington.
³ Department of Global Health, University of Washington Department of Medicine, University of Washington.
⁴ Department of Global Health, University of Washington.
⁵ Department of Biostatistics, University of Washington Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
⁶ Wits Reproductive Health and HIV Institute, University of Witwatersrand, Johannesburg.
⁷ Perinatal HIV Research Unit, Soweto, South Africa.
⁸ Department of Global Health, University of Washington Department of Epidemiology, University of Washington.
⁹ Department of Medicine, University of Manitoba, Winnipeg, Canada.
¹⁰ Department of Molecular Medicine and Haematology, University of Witwatersrand, Johannesburg.
¹¹ Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, United Kingdom.
¹² Department of Global Health, University of Washington Department of Medicine, University of Washington Department of Laboratory Medicine, University of Washington Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.

Abstract

Human immunodeficiency virus (HIV)-infected persons have higher rates of herpes zoster than HIV-uninfected individuals. We assessed whether twice daily treatment with 400 mg of oral acyclovir reduces the incidence of herpes zoster in a randomized, double-blind, placebo-controlled trial among 3408 persons coinfected with HIV and herpes simplex virus type 2. During 5175 person-years of follow-up, 26 cases of herpes zoster occurred among those assigned acyclovir, compared with 69 cases among those assigned placebo (rates, 1.00 and 2.68/100 person-years, respectively), a relative decrease of 62% (hazard ratio, 0.38; 95% confidence interval, .24-.67; P < .001). Daily acyclovir prophylaxis significantly reduced herpes zoster incidence among HIV-infected persons.

Keywords: HIV; VZV; acyclovir; acyclovir prophylaxis; herpes zoster; shingles.

Publication types

Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Acyclovir / administration & dosage*
Adult
Antiviral Agents / administration & dosage*
Chemoprevention / methods*
Double-Blind Method
Female
HIV
HIV Infections / complications*
Herpes Zoster / epidemiology*
Herpes Zoster / prevention & control*
Herpesvirus 2, Human
Humans
Incidence
Male
Placebos / administration & dosage
Treatment Outcome
Young Adult

Substances

Antiviral Agents
Placebos
Acyclovir

Abstract

Publication types

MeSH terms

Substances

Grants and funding