Effect of Monotherapy with Darunavir/Ritonavir on Viral Load in Seminal Fluid, and Quality Parameters of Semen in HIV-1-Positive Patients

Abstract

Patients with human immunodeficiency virus type 1 (HIV-1) who receive antiretroviral therapy (ART) often achieve increased survival and improved quality of life. In this respect, monotherapy with darunavir/ritonavir (mDRV/r) can be a useful treatment strategy. This prospective study analyses the effect of mDRV/r on sperm quality and viral load in a group of 28 patients who had previously been given conventional ART and who had recorded a viral load <20 copies/mL for at least six months. These patients were given mDRV/r at a dose of 800/100 mg for 48 weeks. At baseline (V0), CD4, CD8, FSH, LH and testosterone levels were measured, together with HIV-1 viral load in plasma and semen. In addition, seminal fluid quality was studied before mDRV/r treatment was prescribed. At week 48 (V1), HIV-1 viral load in plasma and semen and the quality of the seminal fluid were again measured. The results obtained indicate that at V0, 10% of the patients with ART had a positive viral load in seminal fluid (>20 copies/ml), and that at V1, after mDRV/r treatment, this figure had fallen to 3%. The quality of seminal fluid was close to normal in 57% of patients at V0 and in 62% at V1. We conclude that, similar to ART, mDRV/r maintains HIV-1 viral load in most patients, and that there is no worsening in seminal fluid quality.

Effect of monotherapy with darunavir/cobicistat on viral load and semen quality of HIV-1 patients

“…The semen quality of patients who are positive for HIV-1 and receiving treatment with ART is known to be impaired [ 4 , 5 ]. A similar decrease has been observed in HIV-1 patients who continue treatment with monotherapy with darunavir/ritonavir (mDRV/r) (800/100mg) [ 6 ].…”

“…The results for viral load and semen quality of these 20 patients, after treatment with mDRV/C for 24 weeks, were compared with those obtained in a previous study performed in 21 patients who after receiving at least 24 weeks of ART, were given mDRV/r for 48 weeks [ 6 ]. Of the 20 patients with mDRV/C, five had previously participated in this previous study of mDRV/r [ 6 ] ( Fig 1 ).…”

“…Very few studies have examined the question of the seminal reservoir in patients receiving monotherapy with protease inhibitors combined with ritonavir [ 6 , 26 ] and our review of the literature did not reveal any that explored the effect of the DRV/C combination in monotherapy, with respect to viral load and to the semen quality of HIV-1 positive patients. To our knowledge, neither have any studies been conducted to evaluate DRV levels in semen with this combination.…”

Darunavir Disrupts Critical Nodes in Metastable 2019-nCoV-RBD/ACE-2 Complex

“…Although both compounds exhibited a good docking score, an initial investigation of both of them showed that darunavir but not ubrogepant had an history as an antiviral compound [17]; therefore, selected for further computational studies. First, the preference of binding was determined using MMPBSA [13] free energy values obtained from 2019-nCoV-RBD in complex with darunavir and those obtained from the candidate bound to 2019-nCoV-RBD/ACE-2.…”

Genetic diversity of HIV in seminal plasma remains higher than in blood after short-term antiretroviral therapy

“…4 Similarly, seminal positive result for HIV RNA was found despite a negative result for HIV RNA was found in blood. 5 Gene sequencing of proviral protease and DNA envelope genes has shown different variants in seminal plasma and blood. 1 The presence of HIV in seminal plasma seems to depend on various factors that may influence its presence in this compartment, even when it is undetectable in blood.…”