Relationship between HIV-RNA load in blood and semen in antiretroviral-naive and experienced men and effect of asymptomatic sexually transmissible infections
We assessed the correlation between HIV-RNA viral load in blood (BPVL) andseminal plasma (SPVL) in a cross-sectional cohort of 119 asymptomatic,antiretroviral-naive and experienced HIV-1 subjects (BPVL < 50 copies/mL forminimum 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 wascollected for CD4 count, BPVL, and general biochemistry and haematology. Semenwas collected concurrently and SPVL determined by the NucliSens HIV-1 QT PCR(BioMerieux, Boxtel, The Netherlands). At a subsequent visit, a second semensample was obtained and SPVL was repeated for 10 subjects on ART. All NNRTIsubjects (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 atbaseline and with repeat sampling. 9/119 subjects (8%) had an asymptomatic STI; 4cases in the treated groups and 5 in the untreated group. Treated subjects wereless likely to have an STI than untreated subjects. In conclusion, asymptomaticSTIs had no effect on BPVL or SPVL in either treated group and SPVL remainsundetectable over time. STIs minimally increase, or do not increase, SPVL inuntreated patients. Our data supports the role of ART in lowering the risk ofsexual transmission of HIV-1.