Potent antiretroviral treatment of HIV-infection results in suppression of the seminal shedding of HIV

Abstract

In patients with treatment-induced suppression of blood viral load the likelihood of having detectable HIV in semen is very low (< 4%). In addition, seminal shedding of cell-free and cell-associated HIV is significantly lower than in an untreated population of HIV-infected asymptomatic men. On a population basis, this effect of therapy may help to reduce sexual transmission of HIV. However, individual patients may still be infected as evidenced by continued shedding of cells harbouring the HIV provirus.

Replicative retroviral vectors for cancer gene therapy

“…55 The patient's immune responses, optionally aided with antiretroviral drugs, should limit viral load and effectively prevent viral dissemination. 56 Finally, it must be emphasized that these first -generation replicative vectors may be improved further. Safety of these vectors can be increased by the addition of propagation constraints and such efforts are already in progress in our laboratory.…”

Quantification of Genital Human Immunodeficiency Virus Type 1 (HIV-1) DNA in Specimens from Women with Low Plasma HIV-1 RNA Levels Typical of HIV-1 Nontransmitters

“…The level of virus in the genital compartment has been presumed to be a primary determinant of HIV-1 infectivity (3,6,27); however, most studies of the viral determinants of HIV-1 transmission have focused on systemic virus. In these analyses, systemic HIV-1 RNA level was a significant predictor of HIV-1 transmission in antiretroviral-naïve serodiscordant couples, and individuals with low plasma HIV-1 RNA levels exhibited low or no risk of transmission (8,10,21,28).…”

Pharmacokinetic Profiles of Nevirapine and Indinavir in Various Fractions of Seminal Plasma

“…The central nervous system and the male genital tract are considered anatomical reservoirs for HIV, as the blood-brain barrier and the blood-testis barrier may prevent antiretroviral drugs from entering these organs. Suboptimal antiretroviral drug concentrations in the male genital tract could allow continuing production of HIV-1 and the emergence of drug-resistant HIV type 1 (HIV-1) strains (4)(5)(6)22).…”