Risk factors for HIV-1 shedding in semen

Carl E. Speck, Robert W. Coombs, Laura A. Koutsky, Judith Zeh, Susan O. Ross, Thomas Hooton, Ann C. Collier, Lawrence Corey, Anne Cent, Joan Dragavon, Willa Lee, Eric J. Johnson, Reigran R. Sampoleo, John N. Krieger

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Abstract

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.

Original languageEnglish
Pages (from-to)622-631
Number of pages10
JournalAmerican Journal of Epidemiology
Volume150
Issue number6
StatePublished - Sep 15 1999
Externally publishedYes

Fingerprint

Virus Shedding
Semen
HIV-1
Odds Ratio
Coculture Techniques
Cytomegalovirus
RNA
Body Fluids
CD4 Lymphocyte Count
Virus Replication
Nucleosides
Up-Regulation
Cell Count
Confidence Intervals
Viruses

Keywords

  • Acquired immunodeficiency syndrome
  • Coculture
  • Cytomegalovirus
  • HIV- 1
  • Polymerase chain reaction
  • RNA, viral
  • Semen

ASJC Scopus subject areas

  • Epidemiology

Cite this

Speck, C. E., Coombs, R. W., Koutsky, L. A., Zeh, J., Ross, S. O., Hooton, T., ... Krieger, J. N. (1999). Risk factors for HIV-1 shedding in semen. American Journal of Epidemiology, 150(6), 622-631.

Risk factors for HIV-1 shedding in semen. / Speck, Carl E.; Coombs, Robert W.; Koutsky, Laura A.; Zeh, Judith; Ross, Susan O.; Hooton, Thomas; Collier, Ann C.; Corey, Lawrence; Cent, Anne; Dragavon, Joan; Lee, Willa; Johnson, Eric J.; Sampoleo, Reigran R.; Krieger, John N.

In: American Journal of Epidemiology, Vol. 150, No. 6, 15.09.1999, p. 622-631.

Research output: Contribution to journalArticle

Speck, CE, Coombs, RW, Koutsky, LA, Zeh, J, Ross, SO, Hooton, T, Collier, AC, Corey, L, Cent, A, Dragavon, J, Lee, W, Johnson, EJ, Sampoleo, RR & Krieger, JN 1999, 'Risk factors for HIV-1 shedding in semen', American Journal of Epidemiology, vol. 150, no. 6, pp. 622-631.
Speck CE, Coombs RW, Koutsky LA, Zeh J, Ross SO, Hooton T et al. Risk factors for HIV-1 shedding in semen. American Journal of Epidemiology. 1999 Sep 15;150(6):622-631.
Speck, Carl E. ; Coombs, Robert W. ; Koutsky, Laura A. ; Zeh, Judith ; Ross, Susan O. ; Hooton, Thomas ; Collier, Ann C. ; Corey, Lawrence ; Cent, Anne ; Dragavon, Joan ; Lee, Willa ; Johnson, Eric J. ; Sampoleo, Reigran R. ; Krieger, John N. / Risk factors for HIV-1 shedding in semen. In: American Journal of Epidemiology. 1999 ; Vol. 150, No. 6. pp. 622-631.
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abstract = "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.",
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