Factors of intermittent HIV-1 excretion in semen and efficiency of sperm processing in obtaining spermatozoa without HIV-1 genomes.
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.
Bujan
Louis
L
CECOS Midi-Pyrénées, the Research Group on Human Fertility and the Fédération de Gynécologie-Obstétrique, University Hospital Paule de Viguier, Toulouse, France.
Daudin
Myriam
M
Matsuda
Tomohiro
T
Righi
Laurence
L
Thauvin
Laurence
L
Berges
Laetitia
L
Izopet
Jacques
J
Berrebi
Alain
A
Massip
Patrice
P
Pasquier
Christophe
C
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
D012367:RNA, Viral