The effects of protease inhibitor therapy on human immunodeficiency virus type 1 levels in semen (AIDS clinical trials group protocol 850).
Antiretroviral therapy may lead to decreased shedding of human immunodeficiency virus type 1 (HIV-1) in genital secretions. Thirty men, 19 receiving amprenavir and 11 receiving amprenavir, zidovudine, and lamivudine, donated blood and semen while undergoing treatment, to evaluate the effects of these medications on HIV-1 shedding in semen. Before therapy, 4 men had HIV-1 RNA levels in seminal plasma >6.0 log10 (1 million) copies/mL, markedly higher than levels in blood plasma. Most men (77%) had HIV-1 RNA levels in seminal plasma below the limit of quantification during therapy. Amprenavir alone suppressed HIV-1 RNA levels to <400 copies/mL in seminal plasma in the majority of patients, the first direct demonstration of the antiretroviral effects of a protease inhibitor in the male genital tract. However, 8 men (27%) had measurable HIV-1 in seminal plasma at their last study visit, 4 with increasing levels. Persistent replication of HIV in the genital tract may have implications for the selection of resistant virus and sexual transmission of HIV-1.
Eron
J J
JJ
Department of Medicine, Infectious Diseases, University of North Carolina, Chapel Hill, NC 27599-7030, USA. jeron@med.unc.edu.
Smeaton
L M
LM
Fiscus
S A
SA
Gulick
R M
RM
Currier
J S
JS
Lennox
J L
JL
D'Aquila
R T
RT
Rogers
M D
MD
Tung
R
R
Murphy
R L
RL
D000328:Adult; D002219:Carbamates; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005663:Furans; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D015497:HIV-1 / Q000302:isolation & purification* / Q000502:physiology; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis / Q000097:blood; D012044:Regression Analysis; D012661:Semen / Q000821:virology*; D013449:Sulfonamides / Q000627:therapeutic use*; D017201:Virus Shedding / Q000187:drug effects; D015215:Zidovudine / Q000627:therapeutic use*
D002219:Carbamates; D005663:Furans; D017320:HIV Protease Inhibitors; D012367:RNA, Viral; D013449:Sulfonamides; D019259:Lamivudine; D015215:Zidovudine; C095108:amprenavir