Relationship between HIV-RNA load in blood and semen in antiretroviral-naïve and experienced men and effect of asymptomatic sexually transmissible infections.

We assessed the correlation between HIV-RNA viral load in blood (BPVL) and seminal plasma (SPVL) in a cross-sectional cohort of 119 asymptomatic, antiretroviral-naive and experienced HIV-1 subjects (BPVL < 50 copies/mL for minimum 12 months and stable on one drug regimen). The cohort was divided into 3 groups: 2 according to the non nucleoside reverse transcriptase inhibitor (NNRTI) and protease inhibitor (PI) used, and 1 untreated group. At the initial visit, subjects were screened for gonorrhoea, chlamydia and syphilis. Blood was collected for CD4 count, BPVL, and general biochemistry and haematology. Semen was collected concurrently and SPVL determined by the NucliSens HIV-1 QT PCR (BioMerieux, Boxtel, The Netherlands). At a subsequent visit, a second semen sample was obtained and SPVL was repeated for 10 subjects on ART. All NNRTI subjects (n = 36, mean treatment 33 months +/- 14) and PI subjects (n = 45, mean treatment 31 months +/- 25) had BPVL < 50 copies/mL and SPVL < 250 copies/mL at baseline and with repeat sampling. 9/119 subjects (8%) had an asymptomatic STI; 4 cases in the treated groups and 5 in the untreated group. Treated subjects were less likely to have an STI than untreated subjects. In conclusion, asymptomatic STIs had no effect on BPVL or SPVL in either treated group and SPVL remains undetectable over time. STIs minimally increase, or do not increase, SPVL in untreated patients. Our data supports the role of ART in lowering the risk of sexual transmission of HIV-1.