CoChat
Sign Up
Cited by 720Herpesvirus Infections and TreatmentsCytomegalovirus and herpesvirus researchHIV/AIDS Research and Interventions

Once-daily valacyclovir to reduce the risk of transmission of genital herpes.

Open access
Corey, Lawrence, Wald, Anna, Patel, Raj, Sacks, Stephen L., Tyring, Stephen K., Warren, Terri, Douglas, John M., Paavonen, Jorma +8 more·2004·New England Journal of Medicine
DOI 10.1056/nejmoa035144
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: 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. METHODS: We followed 1484 immunocompetent, heterosexual, monogamous couples: one with clinically symptomatic genital HSV-2 and one susceptible to HSV-2. The partners with HSV-2 infection were randomly assigned to receive either 500 mg of valacyclovir once daily or placebo for eight months. The susceptible partner was evaluated monthly for clinical signs and symptoms of genital herpes. Source partners were followed for recurrences of genital herpes; 89 were enrolled in a substudy of HSV-2 mucosal shedding. Both partners were counseled on safer sex and were offered condoms at each visit. The predefined primary end point was the reduction in transmission of symptomatic genital herpes. RESULTS: Clinically symptomatic HSV-2 infection developed in 4 of 743 susceptible partners who were given valacyclovir, as compared with 16 of 741 who were given placebo (hazard ratio, 0.25; 95 percent confidence interval, 0.08 to 0.75; P=0.008). Overall, acquisition of HSV-2 was observed in 14 of the susceptible partners who received valacyclovir (1.9 percent), as compared with 27 (3.6 percent) who received placebo (hazard ratio, 0.52; 95 percent confidence interval, 0.27 to 0.99; P=0.04). HSV DNA was detected in samples of genital secretions on 2.9 percent of the days among the HSV-2-infected (source) partners who received valacyclovir, as compared with 10.8 percent of the days among those who received placebo (P<0.001). The mean rates of recurrence were 0.11 per month and 0.40 per month, respectively (P<0.001). CONCLUSIONS: Once-daily suppressive therapy with valacyclovir significantly reduces the risk of transmission of genital herpes among heterosexual, HSV-2-discordant couples.

Integrity signals

Registry

Crossref · 10.1056/nejmoa035144

Cites

35 of 35 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Treatment with valacyclovir 500 mg daily decreases the rate of HSV-2 transmission for discordant heterosexual couples in which a partner has a history of genital HSV-2 infection.

    “Treatment with valacyclovir 500 mg daily decreases the rate of HSV-2 transmission for discordant heterosexual couples in which a partner has a history of genital HSV-2 infection (473).”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [473]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Corey, L., Wald, A., Patel, R., Sacks, S. L., Tyring, S. K., Warren, T., Douglas, J. M., Paavonen, J., Morrow, R. A., Beutner, K. R., Stratchounsky, L. S., Mertz, G., Keene, O. N., Watson, H. A., Tait, D., & Vargas-Cortes, M.
Affiliations
  • University of Washington (US)
  • Royal South Hants Hospital (GB)
  • University of British Columbia (CA)
  • The University of Texas Medical Branch at Galveston (US)
  • Westover Heights Clinic (US)
  • University of Helsinki (FI)
  • University of California, San Francisco (US)
  • University of New Mexico (US)
  • GlaxoSmithKline (United Kingdom) (GB)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2004-01
Volume
350
Issue
1
Pages
11-20
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa035144
OpenAlex
W2083083619
Cited by
720
References
35
Citations by year
2026: 16 · 2025: 13 · 2024: 14 · 2023: 27 · 2022: 18 · 2021: 17 · 2020: 21 · 2019: 16 · 2018: 15 · 2017: 26 · 2016: 31 · 2015: 31 · 2014: 31 · 2013: 33 · 2012: 39
FWCI
36.25
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Allergy and Infectious Diseases (AI 30731, P01AI030731)
Topics
  • Health Sciences › Medicine › Epidemiology › Herpesvirus Infections and Treatments
  • Health Sciences › Medicine › Epidemiology › Cytomegalovirus and herpesvirus research
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Keywords
valacyclovir, genital herpes, herpes simplex virus type 2, HSV-2 transmission, suppressive antiviral therapy, once-daily dosing, condom use
MeSH terms
Valacyclovir, Acyclovir, Adolescent, Adult, Aged, Antiviral Agents, Drug Administration Schedule, Female, Herpes Genitalis, Humans, Male, Middle Aged, Valine, Virus Activation, Herpesvirus 2, Human, Disease Transmission, Infectious, Safe Sex

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review