Disproportionately high semen shedding of HIV is associated with compartmentalized cytomegalovirus reactivation.
Semen transmission of human immunodeficiency virus (HIV) drives the global pandemic. HIV loads are generally lower in semen than in blood, but semen loads may be disproportionately high in a subgroup of men. HIV loads in semen exceeded those in blood in 9 (35%) of 26 of antiretroviral therapy-naive men, and disproportionately high shedding was strongly associated with compartmentalized semen cytomegalovirus (CMV) reactivation (odds ratio [OR], 10.5; P<.01). Overall, 17 of 26 participants were shedding CMV in semen. Semen levels of HIV and CMV were closely correlated (r=0.5; P<.01), independently of blood HIV load and CD4(+) T cell count. Prevention of CMV reactivation warrants further study as a possible strategy to reduce semen shedding of HIV.
Sheth
Prameet M
PM
Department of Medicine, University of Toronto, Mount Sinai Hospital, Canada.
Danesh
Ali
A
Sheung
Anthony
A
Rebbapragada
Anuradha
A
Shahabi
Kamnoosh
K
Kovacs
Colin
C
Halpenny
Roberta
R
Tilley
David
D
Mazzulli
Tony
T
MacDonald
Kelly
K
Kelvin
David
D
Kaul
Rupert
R
D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology*; D003586:Cytomegalovirus Infections / Q000150:complications / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D015658:HIV Infections / Q000150:complications / Q000821:virology*; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology*; D006801:Humans; D008297:Male; D012367:RNA, Viral / Q000032:analysis / Q000097:blood; D012661:Semen / Q000821:virology*; D014775:Virus Activation; D017201:Virus Shedding
D004279:DNA, Viral; D012367:RNA, Viral