TY - JOUR
T1 - Risk factors for HIV-1 shedding in semen
AU - Speck, Carl E.
AU - Coombs, Robert W.
AU - Koutsky, Laura A.
AU - Zeh, Judith
AU - Ross, Susan O.
AU - Hooton, Thomas M.
AU - Collier, Ann C.
AU - Corey, Lawrence
AU - Cent, Anne
AU - Dragavon, Joan
AU - Lee, Willa
AU - Johnson, Eric J.
AU - Sampoleo, Reigran R.
AU - Krieger, John N.
N1 - Funding Information:
Supported by NIH grant nos. DK-49477, AI-27664, AI-30731, and AI-27757 and the Paul G. Allen Foundation for Medical Research. Dr. Speck was a University of Washington NIH/NIAID STD/HIV Predoctoral trainee, supported by grant no. 05-T32-AI-07140.
PY - 1999/9/15
Y1 - 1999/9/15
N2 - Semen is the body fluid most commonly associated with sexual transmission of human immunodeficiency virus type-1 (HIV-1). Because the male genitourinary tract is distinct immunologically from blood, compartment- dependent factors may determine HIV-1 shedding in semen. To identify these factors, the authors obtained 411 semen and blood specimens from 149 men seen up to three times. Seminal plasma was assayed for HIV-1 RNA and semen was cocultured for HIV-1 and cytomegalovirus (CMV), which may up-regulate HIV-1 replication. The best multivariate model for predicting a positive semen HIV- 1 coculture included two local urogenital factors, increased seminal polymorphonuclear cell count (odds ratio (OR) = 12.6 for each log10 increase/mL, 95% confidence interval (Cl) 12.2, 134.5) and a positive CMV coculture (OR = 3.0, 95% Cl 1.2, 7.7). The best multivariate model for predicting semen HIV-1 RNA included two systemic host factors, CD4+ cell counts <200/μliter (OR = 3.0, 95 percent Cl 1.3, 6.9) and nucleoside antiretroviral therapy (monotherapy: OR = 0.5, 95% Cl 0.3, 1.0; combination therapy: OR = 0.4, 95% Cl 0.2, 0.9), and a positive CMV coculture (OR = 1.7, 95% Cl 1.0, 3.0). Thus, both systemic and local genitourinary tract factors influence the risk of semen HIV-1 shedding. These findings suggest that measures of systemic virus burden alone may not predict semen infectivity reliably.
AB - Semen is the body fluid most commonly associated with sexual transmission of human immunodeficiency virus type-1 (HIV-1). Because the male genitourinary tract is distinct immunologically from blood, compartment- dependent factors may determine HIV-1 shedding in semen. To identify these factors, the authors obtained 411 semen and blood specimens from 149 men seen up to three times. Seminal plasma was assayed for HIV-1 RNA and semen was cocultured for HIV-1 and cytomegalovirus (CMV), which may up-regulate HIV-1 replication. The best multivariate model for predicting a positive semen HIV- 1 coculture included two local urogenital factors, increased seminal polymorphonuclear cell count (odds ratio (OR) = 12.6 for each log10 increase/mL, 95% confidence interval (Cl) 12.2, 134.5) and a positive CMV coculture (OR = 3.0, 95% Cl 1.2, 7.7). The best multivariate model for predicting semen HIV-1 RNA included two systemic host factors, CD4+ cell counts <200/μliter (OR = 3.0, 95 percent Cl 1.3, 6.9) and nucleoside antiretroviral therapy (monotherapy: OR = 0.5, 95% Cl 0.3, 1.0; combination therapy: OR = 0.4, 95% Cl 0.2, 0.9), and a positive CMV coculture (OR = 1.7, 95% Cl 1.0, 3.0). Thus, both systemic and local genitourinary tract factors influence the risk of semen HIV-1 shedding. These findings suggest that measures of systemic virus burden alone may not predict semen infectivity reliably.
KW - Acquired immunodeficiency syndrome
KW - Coculture
KW - Cytomegalovirus
KW - HIV- 1
KW - Polymerase chain reaction
KW - RNA, viral
KW - Semen
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U2 - 10.1093/oxfordjournals.aje.a010061
DO - 10.1093/oxfordjournals.aje.a010061
M3 - Article
C2 - 10490002
AN - SCOPUS:0033568771
VL - 150
SP - 622
EP - 631
JO - American Journal of Epidemiology
JF - American Journal of Epidemiology
SN - 0002-9262
IS - 6
ER -
