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. 1999 Aug;75(4):261–263. doi: 10.1136/sti.75.4.261

Asymptomatic urethritis and detection of HIV-1 RNA in seminal plasma

A J Winter, S Taylor, J Workman, D White, J D Ross, A V Swan, D Pillay
PMCID: PMC1758225  PMID: 10615314

Abstract

OBJECTIVE: To define risk factors for detection of HIV-1 RNA in semen in men attending the two largest HIV clinics in the West Midlands. METHODS: 94 HIV-1 seropositive men at any stage of infection donated matched semen and blood samples. 36 subjects (38%) were on no antiretroviral treatment, 12 (13%) were on dual therapy, and 46 (49%) were on three or more drugs. Median CD4 count was 291 cells x 10(6)/l. 87 subjects underwent a urethritis screen (Gram stained urethral smear and culture for gonococcus, and LCR for Chlamydia trachomatis on first pass urine). Quantitative cell free HIV-1 RNA was determined by commercial nucleic acid sequence based assay with a lower detection limit of 800 copies/ml for semen and 400 copies/ml for blood. Independent risk factors for seminal HIV RNA detection were defined by logistic regression. RESULTS: In univariate analysis, subjects not taking antiretrovirals were 11 times more likely to shed HIV RNA (21/36 (58%) v 6/58 (10%); p < 0.0001). Seven subjects (8%) had urethritis (including one C trachomatis infection). Urethritis was significantly associated with detection of seminal HIV RNA (adjusted OR, 80.2; p = 0.006), as was blood plasma viral load (adj OR, 19.3 per factor 10 increase; p < 0.001) and age (adj OR, 1.16 per 1 year older; p = 0.001). Antiviral treatment status, absolute CD4 and CD8 count, clinical stage, treatment centre, ethnicity, and risk factor were not independent predictors. No subject with undetectable blood viral load had detectable seminal HIV RNA. CONCLUSION: Asymptomatic urethritis is independently associated with seminal HIV RNA shedding. 




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Selected References

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  1. Anderson D. J., O'Brien T. R., Politch J. A., Martinez A., Seage G. R., 3rd, Padian N., Horsburgh C. R., Jr, Mayer K. H. Effects of disease stage and zidovudine therapy on the detection of human immunodeficiency virus type 1 in semen. JAMA. 1992 May 27;267(20):2769–2774. [PubMed] [Google Scholar]
  2. Atkins M. C., Carlin E. M., Emery V. C., Griffiths P. D., Boag F. Fluctuations of HIV load in semen of HIV positive patients with newly acquired sexually transmitted diseases. BMJ. 1996 Aug 10;313(7053):341–342. doi: 10.1136/bmj.313.7053.341. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bagasra O., Farzadegan H., Seshamma T., Oakes J. W., Saah A., Pomerantz R. J. Detection of HIV-1 proviral DNA in sperm from HIV-1-infected men. AIDS. 1994 Dec;8(12):1669–1674. doi: 10.1097/00002030-199412000-00005. [DOI] [PubMed] [Google Scholar]
  4. Cohen M. S., Hoffman I. F., Royce R. A., Kazembe P., Dyer J. R., Daly C. C., Zimba D., Vernazza P. L., Maida M., Fiscus S. A. Reduction of concentration of HIV-1 in semen after treatment of urethritis: implications for prevention of sexual transmission of HIV-1. AIDSCAP Malawi Research Group. Lancet. 1997 Jun 28;349(9069):1868–1873. doi: 10.1016/s0140-6736(97)02190-9. [DOI] [PubMed] [Google Scholar]
  5. Dyer J. R., Eron J. J., Hoffman I. F., Kazembe P., Vernazza P. L., Nkata E., Costello Daly C., Fiscus S. A., Cohen M. S. Association of CD4 cell depletion and elevated blood and seminal plasma human immunodeficiency virus type 1 (HIV-1) RNA concentrations with genital ulcer disease in HIV-1-infected men in Malawi. J Infect Dis. 1998 Jan;177(1):224–227. doi: 10.1086/517359. [DOI] [PubMed] [Google Scholar]
  6. Dyer J. R., Gilliam B. L., Eron J. J., Jr, Grosso L., Cohen M. S., Fiscus S. A. Quantitation of human immunodeficiency virus type 1 RNA in cell free seminal plasma: comparison of NASBA with Amplicor reverse transcription-PCR amplification and correlation with quantitative culture. J Virol Methods. 1996 Jul;60(2):161–170. doi: 10.1016/0166-0934(96)02063-0. [DOI] [PubMed] [Google Scholar]
  7. Eron J. J., Vernazza P. L., Johnston D. M., Seillier-Moiseiwitsch F., Alcorn T. M., Fiscus S. A., Cohen M. S. Resistance of HIV-1 to antiretroviral agents in blood and seminal plasma: implications for transmission. AIDS. 1998 Oct 22;12(15):F181–F189. doi: 10.1097/00002030-199815000-00003. [DOI] [PubMed] [Google Scholar]
  8. Gilliam B. L., Dyer J. R., Fiscus S. A., Marcus C., Zhou S., Wathen L., Freimuth W. W., Cohen M. S., Eron J. J., Jr Effects of reverse transcriptase inhibitor therapy on the HIV-1 viral burden in semen. J Acquir Immune Defic Syndr Hum Retrovirol. 1997 May 1;15(1):54–60. doi: 10.1097/00042560-199705010-00009. [DOI] [PubMed] [Google Scholar]
  9. Gupta P., Mellors J., Kingsley L., Riddler S., Singh M. K., Schreiber S., Cronin M., Rinaldo C. R. High viral load in semen of human immunodeficiency virus type 1-infected men at all stages of disease and its reduction by therapy with protease and nonnucleoside reverse transcriptase inhibitors. J Virol. 1997 Aug;71(8):6271–6275. doi: 10.1128/jvi.71.8.6271-6275.1997. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Krieger J. N., Coombs R. W., Collier A. C., Ho D. D., Ross S. O., Zeh J. E., Corey L. Intermittent shedding of human immunodeficiency virus in semen: implications for sexual transmission. J Urol. 1995 Sep;154(3):1035–1040. [PubMed] [Google Scholar]
  11. Krieger J. N., Coombs R. W., Collier A. C., Ross S. O., Speck C., Corey L. Seminal shedding of human immunodeficiency virus type 1 and human cytomegalovirus: evidence for different immunologic controls. J Infect Dis. 1995 Apr;171(4):1018–1022. doi: 10.1093/infdis/171.4.1018. [DOI] [PubMed] [Google Scholar]
  12. Quayle A. J., Xu C., Mayer K. H., Anderson D. J. T lymphocytes and macrophages, but not motile spermatozoa, are a significant source of human immunodeficiency virus in semen. J Infect Dis. 1997 Oct;176(4):960–968. doi: 10.1086/516541. [DOI] [PubMed] [Google Scholar]
  13. Vernazza P. L., Gilliam B. L., Dyer J., Fiscus S. A., Eron J. J., Frank A. C., Cohen M. S. Quantification of HIV in semen: correlation with antiviral treatment and immune status. AIDS. 1997 Jul;11(8):987–993. [PubMed] [Google Scholar]
  14. Vernazza P. L., Gilliam B. L., Flepp M., Dyer J. R., Frank A. C., Fiscus S. A., Cohen M. S., Eron J. J. Effect of antiviral treatment on the shedding of HIV-1 in semen. AIDS. 1997 Aug;11(10):1249–1254. doi: 10.1097/00002030-199710000-00008. [DOI] [PubMed] [Google Scholar]

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