HSV (Herpes Simplex Virus) is the leading cause of genital ulcers in both developed and developing countries. According to a recent study on valacyclovir given once daily to a patient with genital herpes, valacyclovir significantly reduces the rate of HSV transmission. This study involved a prospective, randomized, placebo-controlled trial of valacyclovir (500 mg/day for 8 months) in 1,484 immunocompetent, heterosexual, monogamous couples that were discordant for herpes simplex virus-2 (HSV-2) symptomatic genital infection. A subset analysis was done in 89 patients to determine the effect of valacyclovir on viral shedding using HSV polymerase chain reaction (PCR) analysis of genital swab specimens. As demonstrated in the study, viral shedding is notably reduced in the source patient. The potential application of this information is important for couples that are discordant for HSV. However, this may have an even more important application for reducing transmission of HIV infection, as these ulcers have high concentrations of HIV in co-infected patients. 
Corey L, Wald A, Patel R, et al. NEJM. 2004;350:11-20

FDA Approves First Oral Fluid Based Rapid HIV Test Kit
The FDA has approved the use of oral fluid samples with a rapid HIV diagnostic test kit that provides screening results with over 99 percent accuracy in as little as 20 minutes. Until now, all rapid HIV tests required the use of blood in order to get such rapid results. In addition to simplifying the testing process and precluding the need for a blood sample, use of the oral collection component reduces risk to healthcare workers performing the test by reducing exposure to blood and sharps. The Centers for Disease Control and Prevention (CDC) has estimated that one fourth of the approximately 900,000 HIV-infected people in the US are not aware that they are infected. 
NATAP - www.natap.org, March 26, 2004

HAART Treatment During Acute HIV-Infection Not Recommended
A recent joint study from Australia and the US concluded that antiretroviral treatment of primary HIV infection (PHI) may not be clinically justified on the basis of current evidence. Where does this leave the clinician who has identified a patient as acutely infected with HIV? In some regards, the question of when to treat in PHI is similar to those patients identified with established infection; however, at the start of the disease course there is the possibility of proportionally larger benefits, making this an important question to answer. Based on the currently published data, there is no clear evidence that patients with access to ART have any greater clinical benefit if therapy is introduced immediately during or prior to their seroconversion illness, nor are there comparative data to suggest that short-term use of HAART during PHI can alter future disease progression. Currently, no evidence from these studies suggests that therapy during PHI results in a reduction in clinical progression compared with use of effective therapy in later disease. 
Smith, Don E. et al. AIDS: Volume 18(5) 26 March 2004 pp 709-718.

Study: Detecting Human Papillomavirus DNA in Men 
A study presented at the Human Papillomavirus 2002 International Conference in Paris evaluated methods for detection of genital human papillomavirus (HPV) DNA in men. In this study, samples were obtained from three consecutive groups of 10 men attending a sexually transmitted disease clinic by use of (1) a saline-wetted Dacron swab alone, (2) a saline-wetted cytobrush, or (3) emery paper (600A-grit Wetordry Tri-M-ite; 3M) abrasion followed by a saline-wetted Dacron swab. By use of a polymerase chain reaction-based assay, 45% of emery-paper samples were found to be positive for -globin, compared with 23% of swab-alone and 0% of cytobrush samples. Subsequently, emery paper and saline-wetted Dacron swabs were used to obtain penile shaft, glans, foreskin, and scrotum samples from 318 male university students. Urine samples were also obtained. Of 1323 samples tested, 1288 (97%) were found to be positive for -globin. HPV DNA was detected in samples from 104 men (33%): 24% from the penile shaft, 16% from the glans, 28% from the foreskin, 17% from the scrotum, and 6% in urine. The HPV prevalence was similar for circumcised and uncircumcised men. Testing multiple sites increased the number of men for whom HPV DNA was detected.
Bethany A. Weaver et al. Evaluation of Genital Sites and Sampling Techniques for Detection of Human Papillomavirus DNA in Men. JID 2004;189:677-685.

Back to Top