Can Ampiclox flush away semen for 5 days

Study objectives

Highly active antiretroviral therapy can effectively lower the virion concentrations of the HI type 1 virus (HIV-1) in the peripheral plasma and in the semen of infected men. The aim of this study was to clarify the question of whether the genital tract of HIV-1 infected men who receive highly active antiretroviral therapy and in whom no virus is detectable in the peripheral plasma contains replicable viruses.

Methods

Samples of peripheral blood and semen were collected from seven HIV-1 infected men who received highly active antiretroviral therapy for 5 to 41 months and in whom viral RNA (less than 50 copies / ml) was no longer detectable in the plasma. These samples were analyzed for cell-associated proviral DNA using a quantitative polymerase chain reaction assay. Replicable viruses were examined using cell co-culture assays. In addition, proviral DNA and replicable viruses from peripheral blood and sperm cells were investigated by sequencing relevant virus genes.

Results

Despite the long-term suppression of HIV-1 RNA in plasma, proviral DNA was found in the sperm cells of four out of seven men. Viruses capable of replication could be obtained from the peripheral blood cells of three men and from the sperm cells of two of these three men. The viruses from the sperm cells did not show any genotypic mutations that would indicate resistance to antiretroviral drugs. They were also macrophage trophic, which is characteristic of sexually transmitted HIV-1 strains.

Conclusions

In HIV-1 infected men on highly active antiretroviral therapy without detectable viral RNA concentrations in the plasma, the virus can still be present in the sperm cells. The virus can therefore continue to be transmitted through sexual intercourse.

How reliable is the detection of HIV-infected cells in the ejaculate? In the method used here, CD8 cells, which inhibit the replication of HIV, are removed. The method is therefore particularly suitable for the detection of latently infected cells. The fact that no cells with resistant HIV were found in the ejaculate also indicates a lack of replication in the genital tract. It is not clear whether these latently infected cells can also replicate HIV under in vivo conditions in the genital tract (CD8 lymphocytes are predominantly found in the ejaculate) and thus lead to HIV transmission. In our own multicenter study, we were able to show that in 114 patients receiving potent antiviral therapy, the HIV-RNA concentration in the ejaculate - a “surrogate marker” for infectivity - also fell below the detection limit. With potent therapy with conventional methods (without CD8 depletion) it has never been possible to cultivate HIV from sperm. Finally, conclusive evidence of a reduction in infectivity during therapy must be provided by means of epidemiological studies.

Pietro Vernazza

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