Taylor S, Pereira A S
Division of Immunity and Infection, University of Birmingham, Birmingham Heartlands Hospital, UK.
Sex Transm Infect. 2001 Feb;77(1):4-11. doi: 10.1136/sti.77.1.4.
Because semen is a major vehicle for the sexual transmission of HIV-1, control of viral replication within the sanctuary of the male genital tract should be a goal of antiretroviral therapy. Local immune responses, virus specific factors, and the degree of viral and cellular trafficking all appear to be important in controlling viral replication and evolution. However, the most important factor influencing viral replication and evolution within the male genital tract may be the disposition of antiretroviral agents into genital tissues and fluids. This review proposes possible mechanisms of antiretroviral distribution into the male genital tract by using other sanctuary barriers; such as the placenta, renal tubules, and blood-brain barrier; as models. In addition, this review summarises recent clinical studies regarding the disposition of currently available antiretroviral drugs into the seminal plasma and discusses some of the difficulties in interpreting drug concentration in the genital tract.
由于精液是HIV-1性传播的主要载体，控制男性生殖道这个“庇护所”内的病毒复制应是抗逆转录病毒疗法的目标。局部免疫反应、病毒特异性因子以及病毒和细胞的转运程度似乎在控制病毒复制和进化方面都很重要。然而，影响男性生殖道内病毒复制和进化的最重要因素可能是抗逆转录病毒药物在生殖组织和体液中的分布情况。本综述通过将其他“庇护所”屏障（如胎盘、肾小管和血脑屏障）作为模型，提出抗逆转录病毒药物在男性生殖道内分布的可能机制。此外，本综述总结了近期关于现有抗逆转录病毒药物在精浆中分布情况的临床研究，并讨论了解释生殖道内药物浓度时的一些困难。
