Episodic Therapy for Genital Herpes in Sub-Saharan Africa: A Pooled Analysis from Three Randomized Controlled Trials

BACKGROUND: A randomized controlled trial in South Africa found a beneficial effect of acyclovir on genital ulcer healing, but no effect was seen in trials in Ghana, Central African Republic and Malawi. The aim of this paper is to assess whether the variation in impact of acyclovir on ulcer healing in these trials can be explained by differences in the characteristics of the study populations. METHODOLOGY/PRINCIPAL FINDINGS: Pooled data were analysed to estimate the impact of acyclovir on the proportion of ulcers healed seven days after randomisation by HIV/CD4 status, ulcer aetiology, size and duration before presentation; and impact on lesional HIV-1. Risk ratios (RR) were estimated using Poisson regression with robust standard errors. Of 1478 patients with genital ulcer, most (63%) had herpetic ulcers (16% first episode HSV-2 ulcers), and a further 3% chancroid, 2% syphilis, 0.7% lymphogranuloma venereum and 31% undetermined aetiology. Over half (58%) of patients were HIV-1 seropositive. The median duration of symptoms before presentation was 6 days. Patients on acyclovir were more likely to have a healed ulcer on day 7 (63% vs 57%, RR = 1.08, 95% CI 0.98-1.18), shorter time to healing (p = 0.04) and less lesional HIV-1 RNA (p = 0.03). Small ulcers (<50 mm(2)), HSV-2 ulcers, first episode HSV-2 ulcers, and ulcers in HIV-1 seropositive individuals responded best but the better effectiveness in South Africa was not explained by differences in these factors. CONCLUSIONS/SIGNIFICANCE: There may be slight benefit in adding acyclovir to syndromic management in settings where most ulcers are genital herpes. The stronger effect among HIV-1 infected individuals suggests that acyclovir may be beneficial for GUD/HIV-1 co-infected patients. The high prevalence in this population highlights that genital ulceration in patients with unknown HIV status provides a potential entry point for provider-initiated HIV testing

SED fitting of nearby galaxies in the Herschel Reference Survey

We compute UV to radio continuum spectral energy distributions of 51 nearby galaxies recently observed with SPIRE onboard Herschel and present infrared colours (in the 25-500 μm spectral range). SPIRE data of normal galaxies are well reproduced with a modified black body (β=2) of temperature T≅q 20 K. In ellipticals hosting a radio galaxy, the far-infrared (FIR) emission is dominated by the synchrotron nuclear emission. The colour temperature of the cold dust is higher in quiescent E-S0a than in star-forming systems probably because of the different nature of their dust heating sources (evolved stellar populations, X-ray, fast electrons) and dust grain properties

Roy C. Corbell papers, MSS.0358

Abstract: Miscellaneous financial documents and copy of General Order No. 38-A, American Expeditionary Forces, February 28, 1919 (letter from General John J. Pershing to soldiers at the end of World War I).Scope and Content Note: Miscellaneous financial documents and copy of General Order No. 38-A, American Expeditionary Forces, February 28, 1919 (letter from General John J. Pershing to soldiers at the end of World War I).Biographical/Historical Note: Roy C. Corbell, oldest son of of Jamie M. and Maggie M. Corbell, was born on 21 July 1895 in Lamar County, Alabama. He enlisted as a private on 18 September 1916, in the Alabama National Guard, Troop B, 1st Cavalry. He served in the cavalry from 28 May 1918 until 23 June 1919. He married Dena Mae Rector, and the couple had seven children. Corbell died 28 May 1973 in Vernon, Alabama