前列腺按摩后液/尿可替代精液用于研究男性泌尿生殖道 HIV-1 脱落。

Post-prostatic massage fluid/urine as an alternative to semen for studying male genitourinary HIV-1 shedding.

机构信息

University of Washington, Box 359909, 325 Ninth Avenue, Seattle, WA 98104-2499, USA.

出版信息

Sex Transm Infect. 2011 Apr;87(3):232-7. doi: 10.1136/sti.2010.047118. Epub 2011 Jan 29.

DOI:10.1136/sti.2010.047118

PMID:21278399

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3075574/

Abstract

OBJECTIVES

Genitourinary tract samples are required to investigate male HIV-1 infectivity. Because semen collection is often impractical, the acceptability, feasibility and validity of post-prostatic massage fluid/urine (post-PMF/U) was evaluated for studying male genitourinary HIV-1 shedding.

METHODS

HIV-1-seropositive men were evaluated after 48 h of sexual abstinence. At each visit, a clinician performed prostatic massage, then post-PMF/U and blood were collected. Participants provided semen specimens 1 week later. An audio computer-assisted self-interview (ACASI) administered after each specimen collection evaluated acceptability, adherence to instructions and recent genitourinary symptoms. HIV-1 RNA was quantified using a real-time PCR assay. Detection and quantitation of HIV-1 RNA and stability over visits were compared for semen, post-PMF/U and blood.

RESULTS

Post-PMF/U was successfully obtained at 106 visits (64%) and semen at 136 visits (81%, p<0.001). In ACASI, discomfort was rated higher for post-PMF/U collection (p=0.003), but there was no significant difference in acceptability. Detection of HIV-1 RNA in post-PMF/U was associated with detection in semen (p=0.02). Semen and post-PMF/U HIV-1-RNA levels were correlated (ρ=0.657, p<0.001). Concordance of results at repeat visits was 78.9% for post-PMF/U (κ=0.519, p=0.02) and 89.5% for both blood and semen (κ=0.774, p=0.001).

CONCLUSIONS

Although semen collections were more successful, both post-PMF/U and semen collections were acceptable to many participants. HIV-1 RNA detection and levels were closely associated in semen and post-PMF/U, and results were relatively stable across visits. To assess male HIV-1 infectivity, post-PMF/U may represent a valid alternative when semen cannot be obtained.

摘要

目的

需要采集泌尿生殖道样本以研究男性 HIV-1 感染性。由于精液采集通常不切实际，因此评估了前列腺按摩后液体/尿液（post-PMF/U）在后前列腺按摩后液体/尿液（post-PMF/U）用于研究男性泌尿生殖道 HIV-1 脱落的可接受性、可行性和有效性。

方法

在禁欲 48 小时后，对 HIV-1 血清阳性男性进行评估。每次就诊时，临床医生都会进行前列腺按摩，然后采集 post-PMF/U 和血液。一周后，参与者提供精液标本。每次标本采集后，通过音频计算机辅助自我访谈（ACASI）评估可接受性、对说明的依从性和近期泌尿生殖系统症状。使用实时 PCR 检测法定量 HIV-1 RNA。比较 semen、post-PMF/U 和 blood 中 HIV-1 RNA 的检测和定量以及在访问期间的稳定性。

结果

在 106 次就诊中（64%）成功获得 post-PMF/U，在 136 次就诊中（81%，p<0.001）获得 semen。在 ACASI 中，post-PMF/U 采集时的不适评分更高（p=0.003），但可接受性无显著差异。post-PMF/U 中 HIV-1 RNA 的检测与 semen 中 HIV-1 RNA 的检测相关（p=0.02）。精液和 post-PMF/U HIV-1-RNA 水平呈正相关（ρ=0.657，p<0.001）。post-PMF/U 重复就诊时的结果一致性为 78.9%（κ=0.519，p=0.02），血液和 semen 均为 89.5%（κ=0.774，p=0.001）。

结论

尽管 semen 采集更成功，但许多参与者都可以接受 post-PMF/U 和 semen 采集。在 semen 和 post-PMF/U 中，HIV-1 RNA 的检测和水平密切相关，并且结果在整个就诊过程中相对稳定。为了评估男性 HIV-1 感染性，当无法获得 semen 时，post-PMF/U 可能是一种有效的替代方法。