Semen decontamination for the elimination of seminal HIV-1

Abstract

The risk of HIV transmission to the female partner, or potential offspring of an HIV-1 infected male can be reduced using semen decontamination procedures prior to assisted reproductive treatment (ART). The objective of this study was to determine the efficiency to decontaminate semen samples (N=186) from 95 HIV-1 sero-positive patients. Aliquots of neat semen were submitted for viral validation by qualitative and quantitative polymerase chain reaction. Semen samples were processed by density gradient centrifugation in combination with a ProInsert™ tube where after aliquots of the processed sperm samples were analysed for the presence of HIV-1. Fifty four percent of all tested neat semen samples tested positive for HIV-1 DNA, RNA or both (13.4%, 11.3% and 29.0%, respectively). From a total of 103 processed sperm samples that were submitted for viral validation, two samples tested positive for HIV-1 DNA and none for RNA. In conclusion, semen processing with the ProInsert™ followed by viral validation of processed sperm samples should be performed when providing assisted reproductive treatment to couples where the male partner is HIV-1 seropositive.

Processing, selecting and ritualizing: ambivalent relationships to semen

“…As Pralat (2014) outlines, 'sperm washing' techniques were developed in the late 1980s in Italy to reduce the risk of HIV transmission to children when using the sperm of HIV-positive men. The study by Fourie et al (2014) from South Africa demonstrates how this technique has been further refined. The authors describe semen processing to remove HIV by discontinuous density gradient centrifugation in combination with the use of a polypropylene tube insert.…”

“…The procedure, which is described in detail in the paper involves collection of semen samples, their decontamination through centrifugation, and cryopreservation of the purified sperm samples. Fourie et al (2014) note, based on other studies, that even among men on antiretroviral (ARV) therapy with undetectable virus in blood plasma, semen samples can contain cell-free virus [HIV-RNA] or cell-associated virus (HIV-DNA), and the 'infectious potential of semen, even from men receiving (ARV therapy), should therefore not be underestimated.' In that study, 32.7% of men with undetectable blood plasma HIV-RNA viral load had HIV-RNA detected in their semen samples.…”

“…As noted by Fourie et al (2014), viral validation of semen and sperm is expensive and may not be possible in some countries owing to a lack of pathology services. In such cases, where untested sperm is used, they recommend semen decontamination, followed by single sperm washing and fertilization through intra-cytoplasmic sperm injection (ICSI).…”

“…One article (Fourie et al, 2014) describes the efficacy of a technique to remove HIV from semen samples in a South African clinic. The other article (Pralat, 2014) takes a broader view, looking at how the areas of HIV and assisted reproduction techniques in biomedicine have affected each other, and how reproduction, HIV and homosexuality are historically linked.…”

Reproductive desires of men and women living with HIV: implications for family planning counselling

“…It involves reproductive counselling guidelines as well as techniques to minimize HIV transmission during conception. RRI techniques vary from low technology (such as timed intercourse and selfinsemination) to high technology techniques (such as IVF with washed sperm) (Bagratee, 2007;Fourie et al, 2015;Mantell et al, 2009;Semprini and Hollander, 2007;Vernazza et al, 2006). Recently, guidelines for safer conception among PLHIV in resource-intensive and resource-limited contexts were developed for South Africa (Bekker et al, 2011).…”