April 8, 2014
This article was reported by NAM aidsmap.
NAM aidsmap reported on a study of HIV viral load in semen of men taking long-term antiretroviral therapy (ART). ART suppresses viral load in blood and semen. An undetectable viral load in blood reduces risk of HIV transmission in heterosexual couples.
French researchers who help HIV serodiscordant couples with conception studied 88 HIV-positive men who visited their clinic between 2006 and 2011. All patients were on ART and had an undetectable viral load in their blood for approximately six months. The researchers used 306 frozen semen samples from participants to determine the viral load in semen and whether this could change in a short period of time. After two to seven days of sexual abstinence, each participant had provided one sample and another an hour later.
The researchers found median viral load was 705 copies per milliliter (ml), but detected higher than 1,000 copies/ml in 11 samples. Of 129 samples from patients with one-hour interval, 12 had different results, with undetectable viral load in one sample and detectable load in the other. Median viral load detected in those samples was 918 copies/ml, but six were higher than 1,000 copies/ml.
The researchers concluded that periodic HIV-1 RNA shedding can occur in semen of patients on ART within a one-hour interval. They note that there is a very low risk of sexual HV transmission when an individual is on effective ART and so far research has not shown that these small variations in viral load have caused sexual transmission of HIV.
The full report, "Timing of Intermittent Seminal HIV-1 RNA Shedding in Patients With Undetectable Plasma Viral Load Under Combination Antiretroviral Therapy," was published in the journal PLOS ONE (PLOS ONE 2014; doi: 10.1037/journalpone.00889922).