Determinants of human immunodeficiency virus DNA and RNA shedding in the anal-rectal canal of homosexual men.
To define the determinants of anal-rectal shedding of human immunodeficiency virus (HIV) DNA and RNA, 374 HIV-seropositive homosexual men were tested. Factors independently associated with detection of anal-rectal HIV DNA included anal-rectal inflammation and detection of anal human papillomavirus DNA; predictors of HIV RNA included detection of anal-rectal HIV DNA, anal-rectal inflammation, and high plasma HIV RNA levels. The latter (>10,000 copies/mL) was the main determinant of anal-rectal HIV RNA shedding when HIV DNA (e.g., HIV-infected cells) was not detected in the anal-rectal sample. The local presence of HIV-infected cells and local inflammation were the principal determinants of HIV RNA among those with low (<10,000 copies/mL) plasma HIV RNA load. Among those with anal-rectal HIV DNA present, increased HIV RNA plasma load did not increase the risk of shedding of HIV RNA into the anal-rectal canal.
Kiviat
N B
NB
Department of Pathology, School of Medicine, University of Washington, and Seattle-King County Department of Public Health 98109, USA. nbk@u.washington.edu
Critchlow
C W
CW
Hawes
S E
SE
Kuypers
J
J
Surawicz
C
C
Goldbaum
G
G
van Burik
J A
JA
Lampinen
T
T
Holmes
K K
KK
D000293:Adolescent; D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000473:pathology / Q000821:virology; D001727:Bisexuality; D004279:DNA, Viral / Q000032:analysis; D006679:HIV Seropositivity / Q000821:virology*; D006716:Homosexuality; D006801:Humans; D007413:Intestinal Mucosa / Q000821:virology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis / Q000097:blood; D012007:Rectum / Q000473:pathology / Q000821:virology*; D017201:Virus Shedding
D004279:DNA, Viral; D012367:RNA, Viral