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Rates of Transmission of HSV-2 Infection to Susceptible Partners, According to Risk Stratum. 

Rates of Transmission of HSV-2 Infection to Susceptible Partners, According to Risk Stratum. 

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Nucleoside analogues against herpes simplex virus (HSV) have been shown to suppress shedding of HSV type 2 (HSV-2) on genital mucosal surfaces and may prevent sexual transmission of HSV. We followed 1484 immunocompetent, heterosexual, monogamous couples: one with clinically symptomatic genital HSV-2 and one susceptible to HSV-2. The partners with H...

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... we evaluat- ed all 41 cases of HSV-2 acquisition, we found that HSV-2 had been acquired by 27 of the susceptible partners of placebo recipients (3.6 percent) as com- pared with 14 of the susceptible partners of valacy- clovir recipients (1.9 percent) (hazard ratio, 0.52; 95 percent confidence interval, 0.27 to 0.99; P=0.04) ( Table 2 and Fig. 1C). More female partners than male partners of placebo-treated subjects acquired HSV-2 infection (7.4 percent vs. 1.8 percent) (Table 3 and Fig. 1D). Time-to-event analysis revealed no evi- dence of a significant difference in treatment effect between susceptible female and male partners (P= 0.73 by the interaction test) (Fig. 1D). ...
Context 2
... hazard ratio for those whose partner was taking valacyclovir was 0. 52 16, 2005 . than in the placebo group for all levels of condom use (Table 3), there was considerable overlap be- tween the groups in the rates of acquisition (see Sup- plementary Appendix 1, available with the full text of this article at www.nejm.org). ...
Context 3
... dom use was defined as a time-dependent covariate. In these multivariate analyses, factors found to in- fluence the risk of HSV-2 transmission significantly were female sex of the susceptible partner, greater number of sexual contacts, and shorter duration of genital herpes in the source partner (Tables 3 and 4). There was no evidence that valacyclovir had a re- duced therapeutic effect when efficacy was exam- ined among subgroups defined by these covariates. ...

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... Treatments are acyclovir, valacyclovir, or famciclovir, with clinical context affecting doses and regimens [5] . Resistance is infrequent except in immunocompromised patients [6] . On the other hand In Unani system of medicine, Herpes is referred to as Namla. ...
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... · Where abstinence is unacceptable to couples, the following risk reduction strategies should be advised: o Selective abstinence during recurrences and prodromes. o Male condoms used consistently and correctly might reduce the risk of genital herpes transmission [123][124][125][126] o Antiviral suppression of the sexual partner with known HSV with aciclovir (400 mg twice daily) or valaciclovir (500 mg once daily) will suppress symptomatic and asymptomatic viral shedding and may reduce transmission risk, [127][128][129][130] and this should be offered to all couples [1D]. · Mothers and pregnant people without known orolabial herpes should be advised to abstain from receptive oral sex during the third trimester, and the two weeks prior to this (due to the incubation period for presenting with first episode genital herpes) to reduce the risk of genital HSV infection [IV, C]. ...
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... (ii) The neuro-epi dermal junction which is already targeted therapeutically by acyclovir. However, this requires uptake into already infected keratinocytes, which may explain its limited effect in treatment and even in prophylaxis where only 48% prevention of transmission to others is achieved (75). Blocking viral exit from epidermal nerves would provide an earlier, more effective strategy particularly as HSV may spread between keratinocytes via interstitial spaces, as well as via cell-to-cell transmission between keratinocytes (76). ...
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