精液中的巨细胞病毒和人类免疫缺陷病毒与男同性恋者。

Cytomegalovirus and human immunodeficiency virus in semen of homosexual men.

机构信息

Bedford Research Foundation Laboratory, Somerville, Massachusetts.

出版信息

Fertil Steril. 2014 Feb;101(2):350-8. doi: 10.1016/j.fertnstert.2013.10.040. Epub 2013 Dec 5.

DOI:10.1016/j.fertnstert.2013.10.040

PMID:24314922

Abstract

OBJECTIVE

To assess the accuracy of serology to predict the presence of cytomegalovirus (CMV) in semen of homosexual men without and with HIV coinfection.

DESIGN

Semen CMV was detected by electron microscopy and by polymerase chain reaction (PCR) amplification; paired serum was tested for CMV IgG/IgM. Semen HIV was detected by reverse transcription-PCR.

SETTING

Licensed clinical and research laboratory.

PATIENT(S): Sixty-eight men.

INTERVENTION(S): None.

MAIN OUTCOME MEASURE(S): Frequency of CMV and HIV in semen.

RESULT(S): Cytomegalovirus was detected by electron microscopy in 3 of 10 specimens examined. Forty-six (89%) of 52 HIV-infected men were seropositive for CMV by combined assay for IgG/IgM; two more (48 of 52, 92%) were seropositive for CMV IgG by separate assay; 25 (48%) of the HIV-infected men had PCR-detectable CMV DNA in at least one semen specimen, 22 of whom (42%) had CMV in all specimens. Nineteen (13%) of the 150 specimens tested positive for HIV, whereas 67 (45%) tested positive for CMV; seven specimens tested positive for both CMV and HIV. Cytomegalovirus, but not HIV, detection in semen correlated with decreased CD4(+) lymphocytes in peripheral blood (<700/μL) but was not accurately predicted by serology, leukocytospermia, or age.

CONCLUSION(S): Cytomegalovirus in semen is not accurately predicted by serology. Sperm banking needs to include direct assessment of CMV in semen specimens. Strategies to eliminate CMV from semen specimens are needed to alleviate the risk of virus transmission.

摘要

目的

评估血清学检测在预测 HIV 合并感染和未合并感染的同性恋男性精液中巨细胞病毒（CMV）存在的准确性。

设计

通过电子显微镜和聚合酶链反应（PCR）扩增检测精液 CMV；配对血清检测 CMV IgG/IgM。通过反转录-PCR 检测精液 HIV。

地点

有执照的临床和研究实验室。

患者

68 名男性。

干预措施

无。

主要观察指标

精液中 CMV 和 HIV 的频率。

结果

在 10 个检查标本中，有 3 个通过电子显微镜检测到 CMV。46 例（52 例中的 89%）HIV 感染男性通过 IgG/IgM 联合检测呈 CMV 血清阳性；另有 2 例（52 例中的 48%）通过单独的 IgG 检测呈 CMV 血清阳性；25 例（52 例中的 48%）HIV 感染男性至少有 1 个精液标本中可检测到 CMV DNA，其中 22 例（42%）所有标本中均有 CMV。19 例（150 例中的 13%）标本检测出 HIV 阳性，而 67 例（150 例中的 45%）检测出 CMV 阳性；7 例标本同时检测出 CMV 和 HIV 阳性。精液中 CMV 的检测，而非 HIV 的检测，与外周血中 CD4（+）淋巴细胞减少（<700/μL）相关，但不能通过血清学、白细胞精液症或年龄准确预测。