title: Effects of medical male circumcision (MC) on plasma HIV viral load in HIV+ HAART naïve men; Rakai, Uganda.
abstract: BACKGROUND
  Medical male circumcision (MC) of HIV-infected men may increase plasma HIV viral load and place female partners at risk of infection. We assessed the effect of MC on plasma HIV viral load in HIV-infected men in Rakai, Uganda.
  
  
  METHODS
  195 consenting HIV-positive, HAART naïve men aged 12 and above provided blood for plasma HIV viral load testing before surgery and weekly for six weeks and at 2 and 3 months post surgery. Data were also collected on baseline social demographic characteristics and CD4 counts. Change in log10 plasma viral load between baseline and follow-up visits was estimated using paired t tests and multivariate generalized estimating equation (GEE).
  
  
  RESULTS
  Of the 195 men, 129 had a CD4 count ≧ 350 and 66 had CD4 <350 cells/mm3. Men with CD4 counts <350 had higher baseline mean log10 plasma viral load than those with CD4 counts ≧ 350 cells/mm3 (4.715 vs 4.217 cps/mL, respectively, p = 0.0005). Compared to baseline, there was no statistically significant increase in post-MC HIV plasma viral loads irrespective of CD4. Multivariate analysis showed that higher baseline log10 plasma viral load was significantly associated with reduction in mean log10 plasma viral load following MC (coef.  = -0.134, p<0.001).
  
  
  CONCLUSIONS
  We observed no increase in plasma HIV viral load following MC in HIV-infected, HAART naïve men.
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda.
authors.forename: Godfrey
authors.initials: G
authors.lastname: Kigozi
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda.
authors.forename: Richard
authors.initials: R
authors.lastname: Musoke
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda.
authors.forename: Nehemiah
authors.initials: N
authors.lastname: Kighoma
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda; Urocare clinic, Kampala, Uganda.
authors.forename: Stephen
authors.initials: S
authors.lastname: Watya
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda; School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: David
authors.initials: D
authors.lastname: Serwadda
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda.
authors.forename: Fred
authors.initials: F
authors.lastname: Nalugoda
authors.affiliation: School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Noah
authors.initials: N
authors.lastname: Kiwanuka
authors.affiliation: School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Fred
authors.initials: F
authors.lastname: Wabwire-Mangen
authors.affiliation: Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Aaron
authors.initials: A
authors.lastname: Tobian
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda; School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Fredrick
authors.initials: F
authors.lastname: Makumbi
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda.
authors.forename: Ronald Moses
authors.initials: RM
authors.lastname: Galiwango
authors.affiliation: College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Nelson
authors.initials: N
authors.lastname: Sewankambo
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda.
authors.forename: James
authors.initials: J
authors.lastname: Nkale
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda.
authors.forename: Grace Kigozi
authors.initials: GK
authors.lastname: Nalwoga
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda.
authors.forename: Margaret
authors.initials: M
authors.lastname: Anyokorit
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda.
authors.forename: Tom
authors.initials: T
authors.lastname: Lutalo
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda; Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Ronald Henry
authors.initials: RH
authors.lastname: Gray
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda; Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Maria Joan
authors.initials: MJ
authors.lastname: Wawer
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D002944:Circumcision, Male; D006678:HIV / Q000302:isolation & purification*; D015658:HIV Infections / Q000097:blood* / Q000188:drug therapy; D006801:Humans; D008297:Male; D014454:Uganda; D019562:Viral Load