Abstract
-
We assessed the correlation between HIV-RNA viral load in blood (BPVL) and
seminal plasma (SPVL) in a cross-sectional cohort of 119 asymptomatic,
antiretroviral-naive and experienced HIV-1 subjects (BPVL < 50 copies/mL for
minimum 12 months and stable on one drug regimen). The cohort was divided into 3
groups: 2 according to the non nucleoside reverse transcriptase inhibitor (NNRTI)
and protease inhibitor (PI) used, and 1 untreated group. At the initial visit,
subjects were screened for gonorrhoea, chlamydia and syphilis. Blood was
collected for CD4 count, BPVL, and general biochemistry and haematology. Semen
was collected concurrently and SPVL determined by the NucliSens HIV-1 QT PCR
(BioMerieux, Boxtel, The Netherlands). At a subsequent visit, a second semen
sample was obtained and SPVL was repeated for 10 subjects on ART. All NNRTI
subjects (n = 36, mean treatment 33 months +/- 14) and PI subjects (n = 45, mean
treatment 31 months +/- 25) had BPVL < 50 copies/mL and SPVL < 250 copies/mL at
baseline and with repeat sampling. 9/119 subjects (8%) had an asymptomatic STI; 4
cases in the treated groups and 5 in the untreated group. Treated subjects were
less likely to have an STI than untreated subjects. In conclusion, asymptomatic
STIs had no effect on BPVL or SPVL in either treated group and SPVL remains
undetectable over time. STIs minimally increase, or do not increase, SPVL in
untreated patients. Our data supports the role of ART in lowering the risk of
sexual transmission of HIV-1.