Abstract
It was demonstrated that combination antiretroviral therapy (cART) reduces the HIV-1 viral load (VL) in the blood and the seminal compartment. Some studies have reported that the seminal HIV-1 VL is undetectable in individuals with an undetectable blood plasma viral load (bpVL) under cART. However, some recent studies have demonstrated that seminal HIV-1 RNA may still be detected, and potentially infectious, even in the case of an undetectable bpVL. The aim of this retrospective study was to determine the detection rate of a seminal VL and whether shedding could be intermittent over a very short time.From January 2006 to December 2011, 88 HIV-1 infected men, enrolled in an Assisted Reproduction program, provided 306 semen samples, corresponding to 177 frozen sperm samples (two samples delivered at a one-hour interval (n = 129) or one sample (n = 48)). All enrolled men were under cART, with an undetectable bpVL for more than 6 months. HIV-1 RNA was quantified in seminal plasma using a Roche COBAS Ampliprep COBAS TaqMan HIV-1 test.Seminal HIV-1 RNA was detected in 23 samples (7.5%) from 17 patients (19.3%). This detection rate was stable over years. With regards to the freezing of two samples delivered at a one-hour interval, the proportion of discordance between the first and second samples was 9.3% (12/129).Our results confirm the intermittent shedding of HIV-1 in semen. While this finding has been shown by studies examining longer time intervals, to our knowledge, this has never been demonstrated over such a short time interval.
Highlights
HIV-1 remains wide spread throughout the population
The detection rate of seminal plasma HIV-1 viral load (spVL) and the rate of patients with at least one seminal plasma sample (SPS) with a detectable viral load were stable over time (Figure 2, Table 1)
We show that HIV-1 RNA levels were above 200 copies/ml in 7.5% (23/306) of the collected seminal plasma samples from patients administered Combination Antiretroviral Therapy (cART) and with undetectable blood plasma HIV-1 RNA for at least 6 months
Summary
HIV-1 remains wide spread throughout the population. There were approximately 6,088 new infections, resulting in a total of 150,000 infected people in France in 2011 [1]. 60% were acquired through heterosexual intercourse, despite the low efficiency of HIV-1 transmission via the sexual route (the risk of male-to-female intra-vaginal HIV-1 transmission is estimated to be approximately 8 per 1000 sexual acts) [2]. In this context, Combination Antiretroviral Therapy (cART) has remarkably improved the quality of life and the life expectancy of the HIV-1 infected population. It has allowed serodifferent couples to consider natural procreation. Using AR, no seroconversion has been reported in serodifferent couples in which the men are HIV-1 infected [4]
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