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Examining the Ability of Herpes Simplex Virus Type 2 (HSV2) Therapy to Reduce HIV Target Cell Numbers in the Cervix

Primary Purpose

Herpes Simplex Type Two Infection, HIV Infections

Status
Completed
Phase
Not Applicable
Locations
Canada
Study Type
Interventional
Intervention
Valacyclovir
Placebo
Sponsored by
University of Toronto
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Herpes Simplex Type Two Infection focused on measuring herpes simplex virus type 2, HIV, genital immunology, CD4+ T cell, valacyclovir, HIV seronegativity

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)FemaleAccepts Healthy Volunteers

Inclusion Criteria:

  • Female
  • HSV2 infected

Exclusion Criteria:

  • HIV infected
  • Pregnant
  • Taking HSV2 therapy
  • Current/recent (past 3 months) genital infection

Sites / Locations

  • Women's Health In Women's Hands

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo

Valacyclovir

Arm Description

Participants will be assigned 2 months of placebo or active drug, with an intervening one month washout period.

Participants will be assigned 2 months of placebo or active drug, with an intervening one month washout period.

Outcomes

Primary Outcome Measures

Number of CD4+ T cells on a cervical cytobrush.

Secondary Outcome Measures

Number of immature dendritic cells on a cervical cytobrush
Proinflammatory cytokine/chemokine levels in cervicovaginal secretions

Full Information

First Posted
July 23, 2009
Last Updated
March 21, 2012
Sponsor
University of Toronto
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1. Study Identification

Unique Protocol Identification Number
NCT00946556
Brief Title
Examining the Ability of Herpes Simplex Virus Type 2 (HSV2) Therapy to Reduce HIV Target Cell Numbers in the Cervix
Official Title
Examining the Ability of HSV2 Therapy to Reduce HIV Target Cell Numbers in the Cervix.
Study Type
Interventional

2. Study Status

Record Verification Date
March 2012
Overall Recruitment Status
Completed
Study Start Date
April 2010 (undefined)
Primary Completion Date
May 2011 (Actual)
Study Completion Date
May 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Toronto

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Herpes simplex virus type 2 (HSV2), the most common cause of genital herpes, increases a woman's risk of HIV acquisition from 3-6 fold, perhaps because HSV2-infected women have increased numbers of HIV "target cells" (CD4 T cells and dendritic cells) in the cervical mucosa. However, recent clinical trials showed no impact of HSV2 suppression on HIV acquisition rates. The reasons for this negative result are unclear. The investigators propose to examine the effect of valacyclovir (a widely used herpes medication) treatment on cervical immunology and HIV target cells in the cervix. The study will take the form of a randomized, double-blind, placebo-controlled crossover trial. Primary endpoints will be (1) the number of CD4 T cells on a cervical cytobrush and (2) the number of immature dendritic cells per cervical cytobrush.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Herpes Simplex Type Two Infection, HIV Infections
Keywords
herpes simplex virus type 2, HIV, genital immunology, CD4+ T cell, valacyclovir, HIV seronegativity

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Participants will be assigned 2 months of placebo or active drug, with an intervening one month washout period.
Arm Title
Valacyclovir
Arm Type
Experimental
Arm Description
Participants will be assigned 2 months of placebo or active drug, with an intervening one month washout period.
Intervention Type
Drug
Intervention Name(s)
Valacyclovir
Intervention Description
1g po od for 2 months
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo po od for 2 months
Primary Outcome Measure Information:
Title
Number of CD4+ T cells on a cervical cytobrush.
Time Frame
Monthly intervals for 5 months
Secondary Outcome Measure Information:
Title
Number of immature dendritic cells on a cervical cytobrush
Time Frame
Monthly intervals for 5 months
Title
Proinflammatory cytokine/chemokine levels in cervicovaginal secretions
Time Frame
Monthly intervals for 5 months

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Female HSV2 infected Exclusion Criteria: HIV infected Pregnant Taking HSV2 therapy Current/recent (past 3 months) genital infection
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Rupert Kaul, MD/PhD
Organizational Affiliation
University of Toronto
Official's Role
Principal Investigator
Facility Information:
Facility Name
Women's Health In Women's Hands
City
Toronto
State/Province
Ontario
Country
Canada

12. IPD Sharing Statement

Citations:
PubMed Identifier
17314521
Citation
Rebbapragada A, Wachihi C, Pettengell C, Sunderji S, Huibner S, Jaoko W, Ball B, Fowke K, Mazzulli T, Plummer FA, Kaul R. Negative mucosal synergy between Herpes simplex type 2 and HIV in the female genital tract. AIDS. 2007 Mar 12;21(5):589-98. doi: 10.1097/QAD.0b013e328012b896.
Results Reference
background
PubMed Identifier
24664172
Citation
Yi TJ, Shannon B, Chieza L, Su D, Saunders M, Tharao W, Huibner S, Remis R, Raboud J, Kaul R. Valacyclovir therapy does not reverse herpes-associated alterations in cervical immunology: a randomized, placebo-controlled crossover trial. J Infect Dis. 2014 Sep 1;210(5):708-12. doi: 10.1093/infdis/jiu163. Epub 2014 Mar 23.
Results Reference
derived

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Examining the Ability of Herpes Simplex Virus Type 2 (HSV2) Therapy to Reduce HIV Target Cell Numbers in the Cervix

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