Plasma and semen viral loads discordance in HIV-positive patients receiving antiretroviral treatment (ART) in Tehran: an implication for a healthy pregnancy

Abstract

Introduction:In human immunodeficiency virus (HIV)-positive patients, viral load replication in blood plasma (BP) and genital fluid, such as semen plasma (SP), are different. Several factors, including HIV concentration in semen, virus infectiousness, and susceptibility of host cells determine the risk of transmission from HIV male patients to their sexual partners. Previous studies had controversial results on the correlation of BP viral load and SP viral load and the impact of antiretroviral therapy (ART) on BP and SP viral load. The aim of the study was to evaluate the impact of different ART regimens on BP and SP viral loads. Material and methods:Nineteen HIV-positive male patients, with a mean age of 35.8 years, were included in the study, each of whom had been receiving various ART regimen for at least six months. Both whole blood and semen samples were collected on the same day and subsequently, HIV-1 RNA copy was measured in both samples for each patient. Results:Our results indicated that in patients who were at least six months under ART regimen, mean HIV RNA copy number in BP and SP were 1,371 copy/ml and 273 copy/ml, respectively. Our results demonstrated a significantly higher BP viral load level than SP viral load (p = 0.001). Moreover, a significant correlation between BP viral load and SP viral load was observed (Pearson correlation = 0.97). Conclusions:We conclude that SP viral load of HIV-positive patients with undetectable BP viral load was below detection range. This point should be communicated to sero-discordant couples who want to have a safe pregnancy and healthy offspring.