Speck CE, Coombs R, Koutsky L, Zeh J, Corey L, Hooton T, Ross S, Krieger J; International Conference on AIDS.
Int Conf AIDS. 1996 Jul 7-12; 11: 37 (abstract no. We.C.334).
Los Angeles, CA, USA. Fax: 818.564.3430. E-mail: cspeck@kpsc.org.
Objective: To define the determinants of HIV shedding in semen in a cohort of HIV-seropositive men. Methods: At each of up to three monthly visits 149 HIV+ men provided blood and semen specimens and were administered a brief behavioral questionnaire. To control for intra-subject correlations between outcomes and covariates all data analyses used logistic regression with random effects models. Seminal plasma was assayed for cell-free HIV genomic RNA using the Amplicor HIV Monitor Test (Roche Diagnostics Inc. Branchburg NJ USA); CD4+ count was categorized using conventional cutpoints; semen cytomegalovirus (CMV) cultures were deemed positive if cultivable CMV was detected in either the pellet or the supernatant; quantitative peripheral blood mononuclear cell culture (PBMC) results were transformed on a log (base 10) scale; and antiretroviral therapy was categorized as either combination therapy (2 or more drugs) monotherapy (one drug only) or no therapy. Results: RNA PCR was performed on 333 of the 411 semen specimens obtained. Overall 101 of the 128 (78.9%) men who were assayed for HIV RNA in seminal plasma using PCR were PCR positive at least once while 201 of the 333 (60.4%) specimens assayed were HIV RNA positive by PCR. The median age of study participants was 36 years and the median CD4+ cell count/mm3 of peripheral blood was 338. The multivariate model that best predicted detection of HIV RNA in the seminal plasma included the following 4 factors: (1) a CD4+ count less than 200 cells/mm3 of peripheral blood (compared to men with 500 or more CD4+ cells/mm3 of peripheral blood; OR = 4.5 95% CI=1.1-17.7); (2) high titers of HIV in PBMCs (OR for each log increase in cultivable HIV detected in cultures = 1.3; 95% CI = 1.0-1.6); (3) a concurrent positive semen CMV culture (OR = 2.4 95% CI = 1.0-5.6); and (4) lack of antiretroviral therapy use (OR for men not taking antiretroviral drugs compared to men on combination therapy = 4.1 95% CI = 0.9-18.6). Other factors such as disease stage seminal leukocytosis semen volume time from collection to semen analysis frequency of ejaculation number of sexual partners age race and smoking status did not contribute to the multivariate model. Conclusions: These data suggest that declining immune competence in combination with high titers of HIV in PBMCs a concurrent CMV positive semen culture and absence of antiretroviral therapy are important predictors of detecting cell-free HIV RNA in semen.
Publication Types:
Keywords:
- AIDS Vaccines
- Acquired Immunodeficiency Syndrome
- Anti-HIV Agents
- CD4 Lymphocyte Count
- CD4-Positive T-Lymphocytes
- Cytomegalovirus
- Cytomegalovirus Infections
- HIV
- HIV Infections
- HIV Seropositivity
- Humans
- Male
- Polymerase Chain Reaction
- Semen
Other ID:
UI: 102219167
From Meeting Abstracts