Abstract
The purpose of this study was to determine the histological distribution of in situ polymerase chain reaction (PCR)-amplified HIV-1 nucleic acids in the male genital tract to elucidate the mechanism of sexual transmission of AIDS. Viral DNA was detected in the testicular tissue of 11 of 12 men with HIV-1 infection using the PCR in situ hybridization technique. The amplified viral DNA localized to many spermatogonia, spermatocytes, and rare spermatids. Relatively few viral infected macrophages were noted, mostly in the prostate. The viral infection was activated given the presence of cDNA sequences consistent with genomic and multiple spliced transcripts as determined by reverse transcription in situ PCR. PCR-amplified viral nucleic acids were not detected in the epithelial of the prostate, epididymis, seminal vesicles, or penis in men with AIDS nor in any genital tract tissues from three boys who died of AIDS acquired in utero. The demonstration that HIV-1 selectively infects the spermatogonia and their progeny suggests that this may serve as a primary source of venereal spread of the virus. Concomitant destruction of these cells by HIV-1 may also explain the marked inhibition of spermatogenesis and severe atrophy that characterizes the testes in AIDS.
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