title: Disproportionately high semen shedding of HIV is associated with compartmentalized cytomegalovirus reactivation.
abstract: 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.
authors.affiliation: Department of Medicine, University of Toronto, Mount Sinai Hospital, Canada.
authors.forename: Prameet M
authors.initials: PM
authors.lastname: Sheth
authors.forename: Ali
authors.initials: A
authors.lastname: Danesh
authors.forename: Anthony
authors.initials: A
authors.lastname: Sheung
authors.forename: Anuradha
authors.initials: A
authors.lastname: Rebbapragada
authors.forename: Kamnoosh
authors.initials: K
authors.lastname: Shahabi
authors.forename: Colin
authors.initials: C
authors.lastname: Kovacs
authors.forename: Roberta
authors.initials: R
authors.lastname: Halpenny
authors.forename: David
authors.initials: D
authors.lastname: Tilley
authors.forename: Tony
authors.initials: T
authors.lastname: Mazzulli
authors.forename: Kelly
authors.initials: K
authors.lastname: MacDonald
authors.forename: David
authors.initials: D
authors.lastname: Kelvin
authors.forename: Rupert
authors.initials: R
authors.lastname: Kaul
mesh_terms: 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
chemical_list: D004279:DNA, Viral; D012367:RNA, Viral