Trial reportPloS one2014
Maternal valacyclovir and infant cytomegalovirus acquisition: a randomized controlled trial among HIV-infected women.
Trial report in PloS one, 2014. 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 26 papers, 3 of them syntheses that pooled 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.
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.
HSV-2 Suppression to Reduce Maternal HIV-1 RNA Levels During Pregnancy and Breastfeeding
Who cites it
26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Efficacy and Safety of Antivirals in Lactating Women with Herpesviridae Infections: A Systematic Review.Viruses · 2025Pooled it
- Cytomegalovirus Infection in Pregnancy Prevention and Treatment Options: A Systematic Review and Meta-Analysis.Viruses · 2023Pooled it
- Cytomegalovirus Infection in Human Immunodeficiency Virus (HIV)-Exposed and HIV-Infected Infants: A Systematic Review.The Journal of infectious diseases · 2016Pooled it
- Congenital Cytomegalovirus and HIV Perinatal Transmission.The Pediatric infectious disease journal · 2018Trial
- Maternal Highly Active Antiretroviral Therapy Reduces Vertical Cytomegalovirus Transmission But Does Not Reduce Breast Milk Cytomegalovirus Levels.AIDS research and human retroviruses · 2017Trial
- Clinical Presentation of Postnatally Acquired Cytomegalovirus Infection in Preterm Infants-A Case Series Report.Children (Basel, Switzerland) · 2025Article
- When and how to intervene to improve the health of children born HIV-free.Journal of the International AIDS Society · 2023Article
- Review
- Less common bacterial, fungal and viral infections: review of management in the pregnant patient.Drugs in context · 2021Review
- Article
- The impact of maternal HIV and malaria infection on the prevalence of congenital cytomegalovirus infection in Western Kenya.Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology · 2019Article
- Cytomegalovirus shedding from breastmilk and mucosal sites in healthy postpartum women: A pilot study.Journal of medical virology · 2019Article
- Human Breast Milk-acquired Cytomegalovirus Infection: Certainties, Doubts and Perspectives.Current pediatric reviews · 2019Review
- Natural history of postnatal rhesus cytomegalovirus shedding by dams and acquisition by infant rhesus monkeys.PloS one · 2018Article
- Cytomegalovirus infection in pregnancy.Birth defects research · 2017Review
- Cytomegalovirus in pregnancy and the neonate.F1000Research · 2017Review
- Cytomegalovirus and paediatric HIV infection.Journal of virus eradication · 2016Article
- Human cytomegalovirus (CMV) in Africa: a neglected but important pathogen.Journal of virus eradication · 2016Article
- Risk of congenital cytomegalovirus infection among HIV-exposed uninfected infants is not decreased by maternal nelfinavir use during pregnancy.Journal of medical virology · 2016Observational
- Cytomegalovirus Infection May Contribute to the Reduced Immune Function, Growth, Development, and Health of HIV-Exposed, Uninfected African Children.Frontiers in immunology · 2016Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundStudies in HIV-1-infected infants and HIV-1-exposed, uninfected infants link early cytomegalovirus (CMV) acquisition with growth delay and cognitive impairment. We investigated maternal valacyclovir to delay infant acquisition of CMV.
methodsPregnant women with HIV-1, HSV-2 and CD4 count >250 cells/µl were randomized at 34 weeks gestation to 500 mg twice-daily valacyclovir or placebo for 12 months. Maternal CMV DNA was measured in plasma at 34 weeks gestation, in cervical secretions at 34 and 38 weeks gestation, and in breast milk at 7 postpartum timepoints; infant CMV DNA was measured in dried blood spots at 8 timepoints including birth.
resultsAmong 148 women, 141 infants were compared in intent-to-treat analyses. Maternal and infant characteristics were similar between study arms. Infant CMV acquisition did not differ between study arms, with 46/70 infants (66%) in placebo arm and 47/71 infants (66%) in the valacyclovir arm acquiring CMV; median time to CMV detection did not differ. CMV DNA was detected in 92% of 542 breast milk specimens with no difference in CMV level between study arms. Change in cervical shedding of CMV DNA between baseline and 38 weeks was 0.40-log greater in the placebo arm than the valacyclovir arm (p = 0.05).
conclusionsIn this cohort of HIV-1-seropositive mothers, two-thirds of infants acquired CMV by one year. Maternal valacyclovir had no effect on timing of infant CMV acquisition or breast milk CMV viral loads, although it modestly reduced cervical CMV shedding. Maternal prophylaxis to reduce infant CMV acquisition warrants further evaluation in trials with antiviral agents. TRIALS REGISTRATION: ClinicalTrials.gov NCT00530777.
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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.