Suppressive valacyclovir therapy: impact on the population spread of HSV-2 infection.

Abstract:

OBJECTIVES:Recent trial results demonstrate that the transmission probability of HSV-2 in monogamous couples is nearly halved by the use of valacyclovir as suppressive therapy. GOAL:The goal of this study is to understand the potential impact of suppressive valacyclovir therapy on the transmission of HSV-2 within a population. STUDY DESIGN:A mathematical model of HSV-2 epidemiology was developed which included suppressive therapy with the efficacy observed in the clinical trial. The model represented HSV-2 spread in an age and sexual activity stratified population where rates of viral shedding declined based on time since infection. The model tested the impact of a range of suppression coverage levels. RESULTS:Suppressive therapy reduces the population incidence of HSV-2. With coverage rates of 3.2%, the incidence of HSV-2 would be reduced by between 1.8% and 2.8%. Higher coverage rates were estimated to reduce the incidence of new cases up to 13%. Starting suppression closer to the time of infection also reduces the incidence of new cases. CONCLUSION:The impact of suppressive therapy on the HSV-2 epidemic is modest at current coverage levels but could be substantially increased with higher rates of diagnosis and a focus on coverage soon after infection.

journal_name

Sex Transm Dis

authors

Williams JR,Jordan JC,Davis EA,Garnett GP

doi

10.1097/01.olq.0000258486.81492.a2

subject

Has Abstract

pub_date

2007-03-01 00:00:00

pages

123-31

issue

3

eissn

0148-5717

issn

1537-4521

pii

00007435-200703000-00001

journal_volume

34

pub_type

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