Evidence map›Paper›PMID 22509337›Full record

Trial reportPloS one2012

Infant safety during and after maternal valacyclovir therapy in conjunction with antiretroviral HIV-1 prophylaxis in a randomized clinical trial.

Alison L Drake, Alison C Roxby, James Kiarie, Barbra A Richardson, Anna Wald, Grace John-Stewart, Carey Farquhar

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00530777 (HSV-2 Suppression to Reduce Maternal HIV-1 RNA Levels During Pregnancy and Breastfeeding), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00530777 phase2completednot on this map

HSV-2 Suppression to Reduce Maternal HIV-1 RNA Levels During Pregnancy and Breastfeeding

TypeinterventionalSponsorUniversity of WashingtonRan2008 to 2010Enrolled148ConditionsHIV Infections, Herpes SimplexArmsvalacyclovir, placebo
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Recruitment and retention of pregnant women into clinical research trials: an overview of challenges, facilitators, and best practices.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2014
    Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 2 countries.

Alison L DrakeDepartment of Global Health, University of Washington, Seattle, Washington, United States of America. adrake2@uw.edu
Alison C Roxby
James Kiarie
Barbra A Richardson
Anna Wald
Grace John-Stewart
Carey Farquhar
University of Washington · USUniversity of Nairobi · KE

Funding

University of Washington/Fred Hutch Center for AIDS ResearchP30AI027757 · NIAID · UNIVERSITY OF WASHINGTON · PI EDWIN ROBERTO ORELLANA · 1988 to 2026
$104.9M
THE PERINATAL COMPLICATIONS OF ASYMPTOMATIC GENITAL HERPES SIMPLEX VIRUSP01AI030731 · NIAID · UNIVERSITY OF WASHINGTON · PI KOELLE, DAVID M · 1991 to 2017
$34.3M
Fogarty International Clinical Research Scholars Support Center @ Vanderbilt-AAMCR24TW007988 · FIC · VANDERBILT UNIVERSITY · PI VERMUND, STEN H. · 2007 to 2011
$27.6M
VENEREAL DISEASET32AI007140 · NIAID · UNIVERSITY OF WASHINGTON · PI Julia Cook Dombrowski · 1985 to 2026
$19.4M
INTERNATIONAL TRAINING GRANT IN EPIDEMIOLOGYD43TW000007 · FIC · UNIVERSITY OF WASHINGTON · PI FARQUHAR, CAREY · 1988 to 2012
$16.3M
Clinical Research in HSV InfectionsK24AI071113 · NIAID · UNIVERSITY OF WASHINGTON · PI WALD, ANNA · 2006 to 2015
$1.7M
Pediatric HIV-1 in Africa: Pathogenesis and ManagementK24HD054314 · NICHD · UNIVERSITY OF WASHINGTON · PI JOHN-STEWART, GRACE C. · 2006 to 2016
$1.2M
HIV-1 and Protective Immunity against Common Childhood PathogensK24AI087399 · NIAID · UNIVERSITY OF WASHINGTON · PI FARQUHAR, CAREY · 2010 to 2014
$647k
HSV-2 suppression to reduce maternal plasma, genital and breast milk HIV-1 levelsR03HD057773 · NICHD · UNIVERSITY OF WASHINGTON · PI FARQUHAR, CAREY · 2008 to 2009
$203k
FIC NIH HHS D43 TW000007FIC NIH HHS D43-TW00007FIC NIH HHS R24 TW007988NIAID NIH HHS K24 AI071113NIAID NIH HHS K24 AI087399NIAID NIH HHS P01 AI030731NIAID NIH HHS P01 AI30731NIAID NIH HHS P30 AI027757NIAID NIH HHS T32 AI007140NIAID NIH HHS T32 AI0714032NICHD NIH HHS K24 HD054314NICHD NIH HHS R03 HD057773NICHD NIH HHS R03 HD057773-02S1
6 · The paper itself

Abstract

backgroundMaternal administration of the acyclovir prodrug valacyclovir is compatible with pregnancy and breastfeeding. However, the safety profile of prolonged infant and maternal exposure to acyclovir in the context of antiretrovirals (ARVs) for prevention of mother-to-child HIV-1 transmission (PMTCT) has not been described.

methodsPregnant Kenyan women co-infected with HIV-1/HSV-2 with CD4 counts > 250 cells/mm(3) were enrolled at 34 weeks gestation and randomized to twice daily 500 mg valacyclovir or placebo until 12 months postpartum. Women received zidovudine from 28 weeks gestation and single dose nevirapine was given to women and infants at the time of delivery for PMTCT. Infant blood was collected at 6 weeks for creatinine and ALT. Breast milk specimens were collected at 2 weeks postpartum from 71 women in the valacyclovir arm; acyclovir levels were determined for a random sample of 44 (62%) specimens. Fisher's Exact and Wilcoxon rank-sum tests were used for analysis.

resultsOne hundred forty-eight women were randomized and 146 mother-infant pairs were followed postpartum. PMTCT ARVs were administered to 98% of infants and all mothers. Valacyclovir was not associated with infant or maternal toxicities or adverse events, and no congenital malformations were observed. Infant creatinine levels were all normal (< 0.83 mg/dl) and median creatinine (median 0.50 mg/dl) and infant growth did not differ between study arms. Acyclovir was detected in 35 (80%) of 44 breast milk samples collected at 2 weeks postpartum. Median and maximum acyclovir levels were 2.62 and 10.15 mg/ml, respectively (interquartile range 0.6-4.19).

conclusionsExposure to PMTCT ARVs and acyclovir after maternal administration of valacyclovir during pregnancy and postpartum to women co-infected with HIV-1/HSV-2 was not associated with an increase in infant or maternal toxicities or adverse events.

trial registrationClinicalTrials.gov NCT00530777.

Indexed as

Drug-Related Side Effects and Adverse ReactionsMothersPrenatal Exposure Delayed EffectsAcyclovirAdultAnti-HIV AgentsCoinfectionFemaleHerpesvirus 2, HumanHIV-1HIV InfectionsHumansInfantInfant, NewbornInfectious Disease Transmission, VerticalMilk, HumanAcyclovirAnti-HIV AgentsValacyclovirValine

Identifiers

PMID22509337
PMCPMC3324503
OpenAlexW2049784350

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.