Pasquier C, Daudin M, Righi L, Berges L, Thauvin L, Berrebi A, Massip P, Puel J, Bujan L, Izopet J
Laboratoire de Virologie, Hôpital Purpan, Toulouse, France.
AIDS. 2000 Sep 29;14(14):2093-9. doi: 10.1097/00002030-200009290-00004.
Use of a motile spermatozoa isolation process was assessed for reducing the transmission of HIV and hepatitis C virus (HCV) during artificial insemination in HIV-serodiscordant couples in which the man is infected.
Thirty-two HIV-1-infected clinically asymptomatic men, having a median CD4 cell count of 396 x 10(6)/l and a median blood plasma HIV-1 RNA content of 414 copies/ml. Of these, 16 were infected with both HIV and HCV.
Motile spermatozoa were isolated from 51 semen samples by density gradient and 'swim-up'. HIV-1 and HCV genomes were detected and quantified in the blood plasma and seminal plasma, and detected in seminal cell fractions obtained during spermatozoa isolation.
HIV-1 RNA was detected in 30% of seminal plasma samples. HIV-1 genomes were found in 18% of seminal cell samples, but in none of the motile spermatozoa fractions after 'swim-up'. There was no correlation between the HIV-1 RNA concentrations in the blood and seminal plasma. HIV-1 genome was detected intermittently in patients who gave more than one sample. HCV RNA was detected in 20% of seminal plasma samples from HCV viraemic patients, but in no seminal cells or motile spermatozoa fractions.
Purification of motile spermatozoa by density gradient plus 'swim-up' reduced the HIV-1 and HCV genomes in the semen of infected individuals to undetectable levels. This method, associated with a standardized virus assay, could be useful for serodiscordant couples (males infected) who wish to have children.
对采用活动精子分离法减少男性感染艾滋病毒的血清学不一致夫妇人工授精期间艾滋病毒和丙型肝炎病毒（HCV）传播的情况进行了评估。
32名感染HIV-1的临床无症状男性，CD4细胞计数中位数为396×10⁶/l，血浆HIV-1 RNA含量中位数为414拷贝/ml。其中16人同时感染了HIV和HCV。
通过密度梯度和“上游”法从51份精液样本中分离出活动精子。在血浆和精浆中检测并定量HIV-1和HCV基因组，并在精子分离过程中获得的精细胞组分中进行检测。
在30%的精浆样本中检测到HIV-1 RNA。在18%的精细胞样本中发现了HIV-1基因组，但在“上游”后的活动精子组分中均未发现。血液和精浆中的HIV-1 RNA浓度之间没有相关性。在提供多个样本的患者中间歇性检测到HIV-1基因组。在HCV病毒血症患者的20%精浆样本中检测到HCV RNA，但在精细胞或活动精子组分中均未检测到。
通过密度梯度加“上游”法纯化活动精子可将感染个体精液中的HIV-1和HCV基因组降低到检测不到的水平。这种方法与标准化病毒检测相结合，可能对希望生育的血清学不一致夫妇（男性感染）有用。
