Semen as the Way Forward to Understand HIV-1 Transmission

Coombs, Robert W.; Krieger, John N.

doi:10.1093/infdis/jiw409

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…Most HIV shedding in asymptomatic patients on effective ART with a low risk of STI and attending a medically assisted reproduction clinic, seems to be linked to the type of antiretroviral regimen and adherence to treatment: HIV shedding is reduced when ART effectiveness and tolerance are improved [ 3 ]. The shedding of HIV into the semen of men on ART may contribute to the residual risk of HIV transmission, but the size of this contribution is not known [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Patterns of residual HIV-1 RNA shedding in the seminal plasma of patients on effective antiretroviral therapy

Pasquier

Walschaerts

Raymond

et al. 2017

Basic Clin. Androl.

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BackgroundMore and more HIV-1-infected men on effective antiretroviral treatment (ART) have unprotected sex in order to procreate. The main factor influencing transmission is seminal HIV shedding. While the risk of HIV transmission is very low, it is difficult to assess in individuals. Nevertheless, it should be quantified.ResultsWe retrospectively analysed seminal plasma HIV-1 shedding by 362 treated HIV-infected men attending a medically assisted reproduction centre (1998–2013) in order to determine its frequency, the impact of the antiretroviral regimen on HIV shedding, and to identify shedding patterns. The HIV-1 virus loads in 1396 synchronized blood and semen samples were measured, and antiretroviral treatment, biological and epidemiological data were recorded.We detected isolated HIV-1 shedding into the seminal plasma in 5.3% of patients on efficient antiretroviral treatment, but there was no association with the HIV antiretroviral drug regimen or the CD4 cell count. These men had undergone more regimen changes since treatment initiation and had been on the ongoing drug regimen longer than the non-shedding men. The patterns of HIV seminal shedding among patients with undetectable HIV blood virus load varied greatly. HIV seminal shedding can occur as long as 5 years after starting antiretroviral treatment.ConclusionsThe seminal HIV load was used to monitor risk for infertile HIV-infected patients on an assisted reproductive technology program. This can still be recommended for patients who recently (6 months) started ART, or those with a poor history of adherence to ART but may also be usefull for some patients during counselling. Residual HIV seminal shedding is probably linked to breaks in adherence to antiretroviral treatment but local genital factors cannot be ruled out.

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Section: Introductionmentioning

confidence: 99%

Patterns of residual HIV-1 RNA shedding in the seminal plasma of patients on effective antiretroviral therapy

Pasquier

Walschaerts

Raymond

et al. 2017

Basic Clin. Androl.

View full text Add to dashboard Cite

show abstract

“…From our perspective, this technical sampling issue stands as a limitation of the work presented by Jenabian and colleagues [8]. When considering the testes as a distinctive anatomical reservoir for HIV persistence during cART, the contribution of testicular-associated HIV-1 to semen is generally considered to be minimal since vasectomy has no effect on the HIV-1 RNA level in seminal plasma and other sources of virus from the more distal genital tract glandular structures are more important sources of semen virus [12, 15, 16]. As a consequence, although the work is certainly of interest, it remains to be seen whether a replication-competent HIV can be found in testes from cART treated patients.…”

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confidence: 99%