Effect of Antiretroviral Therapy on HIV Shedding in Semen

  1. Paulo F. Barroso, MD, PhD;
  2. Mauro Schechter, MD, PhD;
  3. Phalguni Gupta, PhD;
  4. Maria F. Melo, BS;
  5. Marcello Vieira, MD;
  6. Fernanda C. Murta, RN;
  7. Yeda Souza; and
  8. Lee H. Harrison, MD
  1. From Hospital Universitário Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland; and University of Pittsburgh, Pittsburgh, Pennsylvania.

    Abstract

    Background: The effect of antiretroviral therapy on seminal HIV shedding in the community remains unknown.

    Objective: To evaluate the effect of antiretroviral therapy on HIV shedding in semen.

    Design: Prospective cohort study.

    Setting: University hospital in Rio de Janeiro, Brazil.

    Patients: 93 HIV-infected men.

    Intervention: Antiretroviral therapy as prescribed by each patient's physician.

    Measurement: HIV RNA in semen and blood plasma before and after introduction of therapy.

    Results: At baseline, HIV RNA was detected in 69 semen samples (74%) and 89 blood samples (96%). Six months after introduction of therapy, HIV RNA was detected in 29 semen samples (33%) and 33 blood samples (38%). The mean reduction in levels of HIV RNA in semen at 6 months was 1.65 log10 units.

    Conclusions: Antiretroviral therapy reduces shedding of HIV in semen, which probably in turn reduces HIV transmissibility. However, a substantial proportion of patients may still be infectious and may have drug-resistant strains of the virus.

    Article and Author Information

    • Acknowledgments: The authors thank Ming Ding for assistance with viral load testing, Ednaura Santos and Elisangela Gonçalves for administrative support, and Clarisse Bressam and Antonieta Bomfim for assistance with data collection. They also thank the patients in the study; Lawrence Moulton for comments and suggestions; and Elizabeth Holt for data management support.

    • Grant Support: In part by a grant/fellowship from Fogarty International Center/USNIH (2D43TW00010) and by the National Program of AIDS/STD-Brazilian Ministry of Health (TC 271/97).

    • Requests for Single Reprints: Paulo F. Barroso, MD, PhD, Laboratório de Pesquisas, Serviço de Doenças Infecciosase Parasitárias, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Avenida Brigadeiro Trompowski s/n, Cidade Universitária, Ilha do Fundão, CEP 21941-950 Rio de Janeiro, Brazil.

    • Requests To Purchase Bulk Reprints (minimum, 100 copies): the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints{at}mail.acponline.org.

    • Current Author Addresses: Drs. Barroso, Schechter, and Vieira, Ms. Melo, Ms. Murta, and Ms. Souza: Laboratório de Pesquisas, Serviço de Doenças Infecciosas e Parasitárias, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Avenida Brigadeiro Trompowski s/n, Cidade Universitária, Ilha do Fundão, CEP 21941-950 Rio de Janeiro, Brazil.

    • Dr. Gupta: Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, 426 Parran Hall, 130 DeSoto Street, Pittsburgh, PA 15261.

    • Dr. Harrison: Infectious Diseases Epidemiology Research Unit, University of Pittsburgh, 521 Parran Hall, 130 DeSoto Street, Pittsburgh, PA 15261.

    • Author Contributions: Conception and design: P.F. Barroso, M. Schechter, L.H. Harrison.

    • Analysis and interpretation of the data: P.F. Barroso, M. Schechter, L.H. Harrison.

    • Drafting of the article: P.F. Barroso, M.F. Melo, L.H. Harrison.

    • Critical revision of the article for important intellectual content: M. Schechter, P. Gupta, M.F. Melo, M. Vieira, F.C. Murta, Y. Souza, L.H. Harrison.

    • Final approval of the article: P.F. Barroso, M. Schechter, P. Gupta, M.F. Melo, M. Vieira, F.C. Murta, Y. Souza, L.H. Harrison.

    • Provision of study materials or patients: P.F. Barroso, M. Schechter, M. Vieira, F.C. Murta.

    • Statistical expertise: P.F. Barroso, L.H. Harrison.

    • Obtaining of funding: P.F. Barroso, M. Schechter, L.H. Harrison.

    • Administrative, technical, or logistic support: P.F. Barroso, M. Schechter, P. Gupta, M.F. Melo, M. Vieira, F.C. Murta, Y. Souza, L.H. Harrison.

    • Collection and assembly of data: P.F. Barroso, M.F. Melo, M. Vieira, F.C. Murta, Y. Souza.

    Summary for Patients

    • Summaries for Patients:The Effect of Anti-HIV Drugs on the Amount of HIV in Semen Ann Intern Med August 15, 2000 133:280
    « Previous | Next Article »Table of Contents

    This Article

    1. Ann Intern Med August 15, 2000 vol. 133 no. 4 280-284
    1. » Abstract
    2. Figures
    3. Full Text
    4. Full Text (PDF)
      1. Summary for Patients

    Rapid Responses

    1. Submit a response
    2. No responses published

    Current Issue

    1. December 1, 2009, 151 (11)
    1. Alert me to current issues