Assisted reproduction in HIV-1-serodifferent couples: the need for viral validation of processed semen.
BACKGROUND
Many HIV-infected men and women have a strong desire for a child. Assisted reproductive technologies (ART) are an option for HIV-serodifferent couples to reduce the risk of HIV transmission from an infected man to the woman. Potential HIV contamination of selected spermatozoa after semen processing is an important issue in this context.


METHODS
HIV in processed semen obtained in our laboratory since 1995 were analysed. HIV RNA and DNA detection was performed in the selected spermatozoa of 125 men. HIV RNA was analysed in blood and semen plasma as well as HIV DNA in non-sperm cells.


RESULTS
HIV RNA and DNA were detected in the selected spermatozoa of eight and two men (6.4% and 1.6%), respectively. HIV RNA was detected with a median load of 5 copies/10(6) spermatozoa. Six of the eight men were untreated, one was taking nucleoside analogue therapy and one was on highly active antiretroviral treatment (HAART). HIV RNA detection was more likely to be positive in selected spermatozoa of men with high seminal plasma viral load. HIV RNA was detected in 26% and 11% of selected spermatozoa fractions when the seminal plasma load was > 10,000 copies/ml and 20-10,000 copies/ml, respectively, but in none when the seminal plasma tested negative.


CONCLUSIONS
Selected spermatozoa may be positive for HIV RNA detection even in treated patients. Viral validation of processed semen is necessary in ART programmes for serodifferent couples, particularly in men with only partially or poorly controlled HIV infection.
Leruez-Ville
Marianne
M
Laboratoire de Virologie, CHU Necker-Enfants Malades, Paris, France.
de Almeida
Marta
M
Tachet
Anne
A
Dulioust
Emmanuel
E
Guibert
Juliette
J
Mandelbrot
Laurent
L
Salmon
Dominique
D
Jouannet
Pierre
P
Rouzioux
Christine
C
D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control*; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012367:RNA, Viral / Q000032:analysis / Q000097:blood; D027724:Reproductive Techniques, Assisted; D012661:Semen / Q000821:virology*; D013048:Specimen Handling / Q000379:methods; D013094:Spermatozoa / Q000821:virology; D019562:Viral Load
D019380:Anti-HIV Agents; D004279:DNA, Viral; D012367:RNA, Viral