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Tenofovir-based PrEP reduced HSV-2 acquisition
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Among men and women, tenofovir-based pre-exposure prophylaxis for HIV also significantly reduced the risk for herpes simplex virus type 2, according to researchers from the University of Washington.
“Given the high prevalence of HSV-2 in HIV-infected persons, and given that HSV-2 is a significant risk factor for HIV acquisition, identifying effective primary prevention strategies for HSV-2 is a public health priority,” the researchers wrote in Annals of Internal Medicine.
This study is a subanalysis of the Partners Pre-exposure Prophylaxis (PrEP) study, which included 4,747 heterosexual, HIV-serodiscordant couples who were randomly assigned to tenofovir (Viread, Gilead Sciences), tenofovir-emtricitabine (Truvada, Gilead Sciences) or placebo to determine the efficacy and safety of PrEP. In this secondary analysis, the researchers evaluated the acquisition of HSV-2 among participants who were seronegative for both HIV and HSV-2 at enrollment.
Among the 1,498 participants who were HSV-2 seronegative at enrollment and had a final study visit sample for HSV-2 testing, 131 developed incident HSV-2 infection. Seventy-nine of the participants were in the PrEP groups for an incidence of 5.6 per 100 person-years. The other 52 were in the placebo group, where there was an incidence of 7.7 per 100 person-years. The hazard ratio for HSV-2 with PrEP, vs. placebo, was 0.70 (95% CI, 0.49-0.99). The absolute risk reduction was 2.1 per 100 person-years.
The researchers also evaluated the risk among 1,044 participants who had partners with HSV-2 infection. The incidence of HSV-2 among the uninfected partners was 10.1 per 100 person-years in the placebo group vs. 7.0 per 100 person-years in the PrEP groups. The hazard ratio for PrEP was 0.67 (95% CI, 0.46-0.98) vs. placebo and the absolute risk reduction was 3.1 per 100 person-years.
“Tenofovir-based PrEP provides modest protection against HSV-2,” the researchers wrote. “The HSV-2 protective effects add benefit to the high protection against HIV in populations who are often at risk for HIV and HSV-2.”
Disclosure: See study for list of disclosures.
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