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Evidence-Based Medicine 2004; 9:146
© 2004 BMJ Publishing Group Ltd.

Therapeutics

Valacyclovir reduced genital herpes transmission in couples discordant for herpes simplex virus type 2 infection

Corey L, Wald A, Patel R, et al. Once-daily valacyclovir to reduce the risk of transmission of genital herpes. N Engl J Med 2004;350:11–20.[Abstract/Free Full Text]

Q In heterosexual couples who are serologically discordant for herpes simplex virus type 2 (HSV-2) infection, does once daily valacyclovir reduce the sexual transmission of genital herpes?

Clinical impact ratings GP/FP/Primary care ******{star} Infectious diseases *****{star}{star}

Key Words: acyclovir • antiviral agents • herpes genitalis • herpesvirus 2 (human)

The first 150 words of the full text of this article appear below.

METHODS
{ebmflochart.f1}Design: randomised placebo controlled trial.

{ebmclsdenvelop.f1}Allocation: concealed.*

{ebmhalfeye.f1}Blinding: blinded {participants, healthcare providers, data collectors, data analysts, and outcome assessors}{dagger}.*

{ebmhourglass.f1}Follow up period: 8 months.

{ebmglobe.f1}Setting: 96 sites in the US, Canada, Europe, Latin America, and Australia.

{ebmpeople.f1}Participants: 1498 couples >=18 years who were immunocompetent, heterosexual, monogamous, in good health, and using effective contraception. One (source) partner had clinically symptomatic genital HSV-2 infection, presence of recurrent genital herpes with <10 episodes/year, and non-use of any daily antiviral therapy. The other (susceptible) partner had HSV-2 seronegativity on Western blot analysis.

{ebmrx.f1}Intervention: oral valacyclovir, 500 mg once daily (n = 743), or matching placebo (n = 741) for source partners. Both partners received counselling on safer sex practices and were offered condoms at monthly visits.

{ebmruler.f1}Outcomes: laboratory confirmed clinically symptomatic first episode of genital HSV-2 infection (susceptible partner) and recurrence of genital HSV-2 infection (source partner).

{ebmrarrow.f1}Participant follow up: 99% (1484 couples, . . . [Full text of this article]

Morten Lindbaek, MD

University of Oslo
Oslo, Norway






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