***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A r and omized cross-over trial of herpes simplex virus type 2 (HSV-2)-suppressive therapy ( valacyclovir , 500 mg twice daily , or placebo for 8 weeks , a 2-week washout period , then the alternative therapy for 8 weeks ) was conducted among 20 Peruvian women coinfected with HSV-2 and human immunodeficiency virus type 1 ( HIV-1 ) who were not on antiretroviral therapy .  Plasma sample s ( obtained weekly ) and endocervical swab specimens ( obtained thrice weekly ) were collected for HIV-1 RNA polymerase chain reaction . Plasma HIV-1 level was significantly lower during the valacyclovir arm , compared with the placebo arm ( -0.26 log10 copies/mL , a 45 % decrease [ P < .001 ] ) , as was cervical HIV-1 level ( -0.35 log10 copies/swab , a 55 % decrease [ P < .001 ] ) . Suppressive HSV-2 therapy has the potential to reduce HIV-1 infectiousness and slow HIV-1 disease progression BACKGROUND Epidemiologic data suggest that infection with herpes simplex virus type 2 ( HSV-2 ) is associated with increased genital shedding of human immunodeficiency virus type 1 ( HIV-1 ) RNA and HIV-1 transmissibility . METHODS We conducted a r and omized , double-blind , placebo-controlled trial of HSV suppressive therapy with valacyclovir ( at a dose of 500 mg twice daily ) in Burkina Faso among women who were seropositive for HIV-1 and HSV-2 ; all were ineligible for highly active antiretroviral therapy . The patients were followed for 24 weeks ( 12 weeks before and 12 weeks after r and omization ) . Regression models were used to assess the effect of valacyclovir on the presence and quantity of genital and plasma HIV-1 RNA and genital HSV-2 DNA during treatment , adjusting for baseline values , and to evaluate the effect over time . RESULTS A total of 140 women were r and omly assigned to treatment groups ; 136 were included in the analyses . At enrollment , the median CD4 cell count was 446 cells per cubic millimeter , and the mean plasma viral load was 4.44 log10 copies per milliliter . With the use of summary - measures analysis , valacyclovir therapy was found to be associated with a significant decrease in the frequency of genital HIV-1 RNA ( odds ratio , 0.41 ; 95 % confidence interval [ CI ] , 0.21 to 0.80 ) and in the mean quantity of the virus ( log(10 ) copies per milliliter , -0.29 ; 95 % CI , -0.44 to -0.15 ) . However , there was no significant decrease in detection of HIV ( risk ratio , 0.93 ; 95 % CI , 0.81 to 1.07 ) . HSV suppressive therapy also reduced the mean plasma HIV-1 RNA level by 0.53 log(10 ) copy per milliliter ( 95 % CI , -0.72 to -0.35 ) . Repeated- measures analysis showed that these effects became significantly stronger during the 3 months of follow-up . CONCLUSIONS HSV suppressive therapy significantly reduces genital and plasma HIV-1 RNA levels in dually infected women . This finding may have important implication s for HIV control . ( Clinical Trials.gov number , NCT00158509 [ Clinical Trials.gov ] . ) BACKGROUND Herpes simplex virus type 2 ( HSV-2 ) infection is common among human immunodeficiency virus (HIV)-infected persons , and HSV reactivation increases plasma and genital HIV-1 levels . We studied HIV-1 levels during HSV suppression in coinfected persons in a placebo-controlled crossover trial . METHODS Twenty antiretroviral therapy (ART)-naive HIV-1/HSV-2-seropositive men who have sex with men in Lima , Peru , with CD4 cell counts > 200 cells/ microL were r and omized to receive either valacyclovir at 500 mg twice daily or placebo for 8 weeks , after which they underwent a 2-week washout period and then received the alternative regimen for 8 weeks . Specimens included daily anogenital swabs ( for HSV DNA polymerase chain reaction [ PCR ] ) , thrice weekly rectal mucosal secretions ( for HIV-1 RNA and HSV DNA PCR ) obtained by anoscopy , and weekly plasma ( for HIV-1 RNA PCR ) . Outcomes were rectal and plasma HIV-1 RNA levels by treatment arm . RESULTS HIV-1 was detected in 73 % of 844 rectal and 99 % of 288 plasma specimens . HSV was detected in 29 % and 4 % of mucocutaneous specimens obtained during placebo and valacyclovir administration , respectively ( P<.001 ) . Valacyclovir result ed in a 0.16 ( 95 % confidence interval [ CI ] , 0.07 - 0.25 ; P=.0008 ; 33 % decrease ) log(10 ) copies/mL lower mean within-subject rectal HIV-1 level and a 0.33 ( 95 % CI , 0.23 - 0.42 ; P<.0001 ; 53 % decrease ) log(10 ) copies/mL lower plasma HIV-1 level , compared with values for placebo . CONCLUSIONS Valacyclovir significantly reduces rectal and plasma HIV-1 levels in HIV-1/HSV-2-coinfected men . HSV suppression may provide clinical benefits to persons not receiving highly active ART as well as public health benefits BACKGROUND Infection with herpes simplex virus type 2 ( HSV-2 ) is associated with an increased risk of acquiring infection with the human immunodeficiency virus ( HIV ) . This study tested the hypothesis that HSV-2 suppressive therapy reduces the risk of HIV acquisition . METHODS Female workers at recreational facilities in northwestern Tanzania who were 16 to 35 years of age were interviewed and underwent serologic testing for HIV and HSV-2 . We enrolled female workers who were HIV-seronegative and HSV-2-seropositive in a r and omized , double-blind , placebo-controlled trial of suppressive treatment with acyclovir ( 400 mg twice daily ) . Participants attended mobile clinics every 3 months for a follow-up period of 12 to 30 months , depending on enrollment date . The primary outcome was the incidence of infection with HIV . We used a modified intention-to-treat analysis ; data for participants who became pregnant were censored . Adherence to treatment was estimated by a tablet count at each visit . RESULTS A total of 821 participants were r and omly assigned to receive acyclovir  ( 400 participants ) or placebo ( 421 participants ) ; 679 ( 83 % ) completed follow-up . Mean follow-up for the acyclovir and placebo groups was 1.52 and 1.62 years , respectively . The incidence of HIV infection was 4.27 per 100 person-years ( 27 participants in the acyclovir group and 28 in the placebo group ) , and there was no overall effect of acyclovir on the incidence of HIV ( rate ratio for the acyclovir group , 1.08 ; 95 % confidence interval , 0.64 to 1.83 ) . The estimated median adherence was 90 % . Genital HSV was detected in a similar proportion of participants in the two study groups at 6 , 12 , and 24 months . No serious adverse events were attributable to treatment with acyclovir . CONCLUSIONS These data show no evidence that acyclovir ( 400 mg twice daily ) as HSV suppressive therapy decreases the incidence of infection with HIV . ( Current Controlled Trials number , IS RCT N35385041 [ controlled-trials.com ] . ) ABSTRACT Data are accumulating on the performance of enzyme immunoassays ( EIAs ) for the detection of herpes simplex virus type 2 ( HSV-2 ) infection in North America and Europe , but little is known about their performance in other population s. Nine test kits were evaluated with 330 serum sample s from sub-Saharan Africa . The tests were first compared to the monoclonal antibody ( MAb ) EIA ( Central Public Health Laboratory , London , United Kingdom ) . Sample s that gave discordant results in the MAb EIA and in the three tests that performed best compared to the MAb EIA were tested by Western blotting ( University of Washington , Seattle ) . A r and om sample of concordant sample s was also tested , and the sensitivities and specificities of the different tests were calculated , taking into account this sampling strategy . The sensitivities of the tests ranged from 86 to 100 % ; the specificities ranged from 47 to 99 % . The tests that performed best were the Gull Premier EIA ( sensitivity , 86.3 % ; specificity , 97.6 % ) and the Kalon Biological ( sensitivity , 92.3 % ; specificity , 97.7 % ) and Biokit ( sensitivity , 86.7 % ; specificity , 92.6 % ) tests . It can not be assumed that enzyme immunoassays for the detection of HSV-2 infection that perform well in industrialized countries will perform equally well in other population Background : Herpes simplex virus type 2 infection is important in the HIV epidemic and may contribute to increased HIV transmission . We evaluated the effect of suppressive acyclovir therapy on cervicovaginal HIV-1 shedding . Methods : HIV-1- and herpes simplex virus type 2-coinfected women aged 18 - 49 years with CD4 counts > 200 cells/μL were enrolled in a r and omized crossover trial of suppressive acyclovir therapy ( NCT00362596 , http://www . clinical trials.gov ) . For each woman , monthly plasma and weekly cervicovaginal lavage specimens were collected ; the mean of the monthly median cervicovaginal lavage HIV-1 viral load and plasma HIV-1 viral load was compared . Results : Sixty-seven women were enrolled ; at baseline , median CD4 count was 366 cells/μL , and median HIV-1 plasma viral load was 4.6 log10 copies/mL.  The mean cervicovaginal lavage HIV-1 viral load was 1.9 ( SD 0.8 ) log10 copies/mL during the acyclovir month and 2.2 ( SD 0.7 ) log10 copies/mL during the placebo month ( P < 0.0001 ) ; the mean decrease in HIV was 0.3 log10 copies/mL. The mean plasma HIV viral load during the acyclovir month ( 3.78 log10 copies/mL ) was reduced compared with the placebo month ( 4.26 log10 copies/mL , P < 0.001 ) . Conclusions : Acyclovir reduced HIV genital shedding and plasma viral load among HIV-1- and herpes simplex virus type 2-coinfected women . Further data from clinical trials will examine the effect of suppressive therapy on HIV transmission Objectives : To determine the prevalence and correlates of herpes simplex virus type 2 ( HSV-2 ) seropositivity among fishermen along the shores of Lake Victoria in Kisumu district , Kenya . Methods : Sera from a r and om sample of 250 fishermen from 18 beaches were collected after a detailed sociodemographic interview . HSV-2 infection was tested by Kalon HSV-2 ELISA . Results : The HSV-2 seroprevalence was 63.9 % . In multivariate analysis , fishermen were more likely to be infected with HSV-2 if they were HIV positive ( prevalence ratio ( PR ) 1.27 ; 95 % CI 1.06 to 1.52 ) compared with those testing HIV negative , were aged 18–20 ( PR 0.49 ; 95 % CI 0.24 to 0.99 ) and older than 40 ( PR 1.66 ; 95 % CI 1.30 to 2.14 ) years compared with those aged 21–25 years , perceived their last two sexual partners to have a sexually transmitted infection ( STI ; PR 1.27 ; 95 % CI 1.06 to 1.52 ) compared with those who did not and were more likely to be circumcised ( PR 1.49 ; 95 % CI 1.19 to 1.86 ) . Conclusions : HSV-2 seroprevalence is high among this population and is associated with HIV serostatus , age , perception about partner ’s STI status and circumcision A serosurvey was conducted in a r and om sample of 259 women and 231 men in 12 rural communities in Mwanza Region , Tanzania , using a  type-specific ELISA for Herpes simplex virus type 2 ( HSV-2 ) infection . Seroprevalence rose steeply with age to approximately 75 % in women > = 25 years old and 60 % in men > = 30 . After adjusting for age and residence , HSV-2 prevalence was higher in women who were married , in a polygamous marriage , Treponema pallidum hemagglutination assay (TPHA)-positive , had more lifetime sex partners , or who had not traveled . Prevalence was 
    Output:
    
Sensitivity and specificity of HSV-2 tests used in sub-Saharan Africa vary by setting , and are lower than reported from studies in the United States and Europe .
Increasing the cut-off optical density index may improve test performance .