title: The effects of urethritis on seminal plasma HIV-1 RNA loads in homosexual men not receiving antiretroviral therapy.
abstract: OBJECTIVE
  To examine the effects of urethritis and its treatment on semen plasma HIV-1 RNA load in HIV-1 infected men not receiving antiretroviral therapy (ART), in a developed world setting.
  
  
  METHODS
  Prospective case-control study. HIV-1 infected homosexual men, not receiving ART for at least 3 months, with (cases) and without (controls) symptomatic urethritis, were recruited. Blood and semen were collected for HIV-1 RNA quantification at presentation, before antibiotic therapy, and at 1 and 2 weeks.
  
  
  RESULTS
  20 cases (13 gonococcal urethritis and/or chlamydial urethritis (GU/CU) and seven non-specific urethritis (NSU)) and 35 controls were recruited. Baseline characteristics and blood plasma viral load were similar in cases and controls. Mean log semen plasma viral loads were higher among those with GU/CU compared with controls (4.27 log versus 3.55 log respectively; p = 0.01) but not in those with NSU (3.48 log; p = 0.82). Following antibiotics, semen plasma viral loads fell by a mean of 0.25 log (95% CI: 0.03 to 0.47) in those with GU/CU. Semen plasma viral loads did not fall in those with NSU.
  
  
  CONCLUSIONS
  In this study of 55 homosexual men not on ART, semen plasma viral loads were approximately fivefold higher in those with GU/CU, but not NSU, compared with controls. Treatment of GU/CU resulted in reduction in semen plasma viral loads. Although absolute effects were considerably lower when compared to patients from a similar study from sub-Saharan Africa, our data demonstrate the potential for sexually transmitted infections to enhance HIV infectivity of men not receiving ART in the developed world.
authors.affiliation: HIV/GUM, Department of Cellular and Molecular Medicine, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK. ssadiq@sghms.ac.uk
authors.forename: S T
authors.initials: ST
authors.lastname: Sadiq
authors.forename: S
authors.initials: S
authors.lastname: Taylor
authors.forename: A J
authors.initials: AJ
authors.lastname: Copas
authors.forename: J
authors.initials: J
authors.lastname: Bennett
authors.forename: S
authors.initials: S
authors.lastname: Kaye
authors.forename: S M
authors.initials: SM
authors.lastname: Drake
authors.forename: S
authors.initials: S
authors.lastname: Kirk
authors.forename: D
authors.initials: D
authors.lastname: Pillay
authors.forename: I V D
authors.initials: IV
authors.lastname: Weller
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002690:Chlamydia Infections; D005260:Female; D005500:Follow-Up Studies; D006069:Gonorrhea / Q000821:virology; D015497:HIV-1; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis*; D012661:Semen / Q000821:virology*; D014526:Urethritis / Q000821:virology*; D019562:Viral Load
chemical_list: D012367:RNA, Viral