title: Factors of intermittent HIV-1 excretion in semen and efficiency of sperm processing in obtaining spermatozoa without HIV-1 genomes.
abstract: OBJECTIVE
  To study the risk factors for HIV-1 in semen according to the localization of HIV-1 in sperm cell fractions and to assess the efficiency of sperm processing in obtaining spermatozoa without HIV-1 genomes.
  
  
  METHODS
  Ninety-four HIV-infected patients provided 281 paired blood and semen samples. Sperm cell separation was performed using two successive methods. HIV-1 RNA was quantified in blood and seminal plasma. HIV-1 RNA and DNA were detected in cell fractions.
  
  
  RESULTS
  HIV-1 RNA was found in 14% of seminal plasma samples and up to 8.7% of native semen cells were positive for HIV-1 RNA and DNA. Ten seminal plasma samples had detectable RNA although blood viral load was undetectable. Antiretroviral treatment reduced the likelihood of RNA detection in seminal plasma. For semen with polynuclear cells and HIV-1 RNA in seminal plasma, the likelihood of detecting HIV-1 genomes in semen cells was increased fourfold and sixfold, respectively. In 25% of patients, HIV-1 excretion was intermittent. In the group of patients with systematic negative seminal plasma, HIV-1 genomes were detected in up to 10% of sperm cell samples. Our method of sperm processing always enabled us to obtain spermatozoa without detectable HIV-1 genomes.
  
  
  CONCLUSIONS
  Polynuclear cells in semen are a risk factor for seminal HIV-1 excretion. Blood viral load was the only predictive factor for the intermittence of HIV-1 excretion in semen over time. Sperm processing using two successive methods was effective in obtaining spermatozoa without detectable HIV-1 genomes regardless of the viral load level in native semen.
authors.affiliation: CECOS Midi-Pyrénées, the Research Group on Human Fertility and the Fédération de Gynécologie-Obstétrique, University Hospital Paule de Viguier, Toulouse, France.
authors.forename: Louis
authors.initials: L
authors.lastname: Bujan
authors.forename: Myriam
authors.initials: M
authors.lastname: Daudin
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Matsuda
authors.forename: Laurence
authors.initials: L
authors.lastname: Righi
authors.forename: Laurence
authors.initials: L
authors.lastname: Thauvin
authors.forename: Laetitia
authors.initials: L
authors.lastname: Berges
authors.forename: Jacques
authors.initials: J
authors.lastname: Izopet
authors.forename: Alain
authors.initials: A
authors.lastname: Berrebi
authors.forename: Patrice
authors.initials: P
authors.lastname: Massip
authors.forename: Christophe
authors.initials: C
authors.lastname: Pasquier
mesh_terms: D000328:Adult; D002469:Cell Separation / Q000379:methods; D015658:HIV Infections / Q000635:transmission*; D015497:HIV-1 / Q000235:genetics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis* / Q000097:blood; D012307:Risk Factors; D012661:Semen / Q000821:virology*; D013094:Spermatozoa / Q000821:virology*; D013997:Time Factors; D020858:Tissue and Organ Harvesting; D019562:Viral Load; D014779:Virus Replication
chemical_list: D012367:RNA, Viral