![]() 2 Sub-Saharan Africa is the most severely affected region of the world up to 80% of sexually active women and up to 50% of sexually active men are infected with HSV-2. survey covering the period from 1999 through 2010 showed a 15.7% prevalence of HSV-2 among persons 14 to 49 years of age. Available global estimates indicate that in 2012 approximately 417 million sexually active adults 15 to 49 years of age had an existing prevalent HSV-2 infection. Globally, herpes simplex virus type 2 (HSV-2) infection is among the most common sexually transmitted infections and is the leading cause of genital ulcers. Agency for International Development and others number, NCT00441298.) Introduction In this study in South Africa, pericoital application of tenofovir gel reduced HSV-2 acquisition in women. As confirmed by Western blot testing, there were 16 HSV-2 seroconversions among women assigned to tenofovir gel as compared with 36 among those assigned to the placebo gel (incidence rate ratio, 0.45 95% CI, 0.23 to 0.82 P=0.005). The HSV-2 incidence rate among the 25 women with vaginal tenofovir concentrations of 10,000 ng per milliliter or more was 5.7 cases per 100 person-years, as compared with 15.5 cases per 100 person-years among the 103 women with no detectable vaginal tenofovir (incidence rate ratio, 0.37 95% CI, 0.04 to 1.51 P=0.14). The HSV-2 incidence rate was 10.2 cases per 100 person-years (95% confidence interval, 6.8 to 14.7) among 202 women assigned to tenofovir gel, as compared with 21.0 cases per 100 person-years (95% CI, 16.0 to 27.2) among 222 women assigned to placebo gel (incidence rate ratio, 0.49 95% CI, 0.30 to 0.77 P=0.003). A confirmatory analysis was performed by Western blot testing. Incident HSV-2 cases were identified by evidence of seroconversion on an HSV-2 IgG enzyme-linked immunosorbent assay between study enrollment and exit. We assessed the effectiveness of pericoital tenofovir gel, an antiviral microbicide, in preventing HSV-2 acquisition in a subgroup of 422 HSV-2–negative women enrolled in the Centre for the AIDS Programme of Research in South Africa (CAPRISA) 004 study, a double-blind, randomized, placebo-controlled trial. Effective prevention strategies for HSV-2 infection are needed to achieve the goals of the World Health Organization global strategy for the prevention and control of sexually transmitted infections. Globally, herpes simplex virus type 2 (HSV-2) infection is the most common cause of genital ulcer disease. The most trusted, influential source of new medical knowledge and clinical best practices in the world. Information and tools for librarians about site license offerings. Valuable tools for building a rewarding career in health care. The authorized source of trusted medical research and education for the Chinese-language medical community. The most advanced way to teach, practice, and assess clinical reasoning skills. Information, resources, and support needed to approach rotations - and life as a resident. The most effective and engaging way for clinicians to learn, improve their practice, and prepare for board exams. NEW! Peer-reviewed journal featuring in-depth articles to accelerate the transformation of health care delivery.Ĭoncise summaries and expert physician commentary that busy clinicians need to enhance patient care. NEW! A digital journal for innovative original research and fresh, bold ideas in clinical trial design and clinical decision-making.
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