title: Higher concentration of HIV RNA in rectal mucosa secretions than in blood and seminal plasma, among men who have sex with men, independent of antiretroviral therapy.
abstract: High levels of human immunodeficiency virus (HIV) in rectal secretions and semen likely increase the risk of HIV transmission. HIV-infected men who have sex with men made 2-3 study visits, over 4 weeks, to assess rectal, seminal, and plasma levels of HIV RNA. Mixed-effects models estimated the effect of factors on HIV shedding. Twenty-seven (42%) of 64 men were receiving antiretroviral therapy (ART); regardless of ART use, median HIV RNA levels were higher in rectal secretions (4.96 log(10) copies/mL) than in blood plasma (4.24 log(10) copies/mL) or seminal plasma (3.55 log(10) copies/mL; P<.05, each comparison). ART was associated with a 1.3-log(10) reduction in rectal HIV RNA in a model without plasma HIV RNA; with and without plasma RNA in models, ART accounted for a >1-log(10) decrease in seminal HIV RNA levels. Thus, controlling for plasma HIV RNA, ART had an independent effect on seminal, but not rectal, HIV levels.
authors.affiliation: Department of Medicine, University of Washington, Seattle 98104, USA. zuckermn@u.washington.edu
authors.forename: Richard A
authors.initials: RA
authors.lastname: Zuckerman
authors.forename: William L H
authors.initials: WL
authors.lastname: Whittington
authors.forename: Connie L
authors.initials: CL
authors.lastname: Celum
authors.forename: Tarquin K
authors.initials: TK
authors.lastname: Collis
authors.forename: Aldo J
authors.initials: AJ
authors.lastname: Lucchetti
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Sanchez
authors.forename: James P
authors.initials: JP
authors.lastname: Hughes
authors.forename: Jose L
authors.initials: JL
authors.lastname: Sanchez
authors.forename: Robert W
authors.initials: RW
authors.lastname: Coombs
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D015658:HIV Infections / Q000188:drug therapy / Q000635:transmission / Q000821:virology*; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification*; D006716:Homosexuality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000821:virology; D012367:RNA, Viral / Q000032:analysis* / Q000097:blood; D012007:Rectum / Q000821:virology*; D012661:Semen / Q000821:virology*
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral