Bradshaw Daniel, Lamoury Francois, Catlett Beth, Applegate Tanya L, Mcallister John, Dore Gregory J, Matthews Gail V, Danta Mark
Kirby Institute Chelsea and Westminster Hospital, London, United Kingdom.
Kirby Institute.
J Infect Dis. 2015 Mar 1;211(5):736-43. doi: 10.1093/infdis/jiu550. Epub 2014 Oct 6.
We aimed to characterize seminal hepatitis C virus (HCV) RNA dynamics in human immunodeficiency virus (HIV)-positive men with acute HCV infection given its potential role in sexual transmission of HCV.
Men with acute HCV infection (duration, ≤12 months) or chronic HCV infection (duration, >12 months) were prospectively recruited. Paired semen and blood samples were assayed for HCV RNA levels. Results were analyzed using χ(2), Fisher exact, Mann-Whitney U, and Kruskal-Wallis tests.
Eighteen men (27.3%) had acute HCV and HIV coinfection, 22 (33.3%) had chronic HCV infection and HIV coinfection, and 26 (39.4%) had chronic HCV monoinfection. HCV RNA was detected in semen specimens from 29 of 66 men (43.9%). The median HCV RNA level in blood was 4.0 log IU/mL higher than that in semen. HCV RNA levels were correlated in semen and blood (r(2) = 0.142). Neither HIV positivity nor acute HCV infection was associated with an increased frequency of seminal HCV RNA detection. Among men with acute HCV and HIV coinfection, the median HCV RNA level in blood specimens from those with seminal HCV RNA was higher than that in blood specimens from those without seminal HCV RNA (P = .001). Seminal HCV RNA was detected in ≥1 sample for 26 of 35 men (74.3%) attending follow up.
HCV RNA was detected in semen during both acute and chronic HCV infection. This was unaffected by HIV positivity or the phase of HCV infection. Elevated seminal HCV RNA levels could contribute to sexual transmission of HCV, but other factors, including high-risk behaviors, may be the main drivers for HCV transmission in HIV-infected individuals.
鉴于丙型肝炎病毒（HCV）在人类免疫缺陷病毒（HIV）阳性男性急性HCV感染中的性传播潜在作用，我们旨在描述其精液中HCV RNA动态变化。
前瞻性招募急性HCV感染（病程≤12个月）或慢性HCV感染（病程>12个月）的男性。对配对的精液和血液样本检测HCV RNA水平。结果采用χ²检验、Fisher精确检验、Mann-Whitney U检验和Kruskal-Wallis检验进行分析。
18名男性（27.3%）为急性HCV和HIV合并感染，22名（33.3%）为慢性HCV感染和HIV合并感染，26名（39.4%）为慢性HCV单一感染。66名男性中有29名（43.9%）精液标本检测到HCV RNA。血液中HCV RNA水平中位数比精液中高4.0 log IU/mL。精液和血液中的HCV RNA水平具有相关性（r² = 0.142）。HIV阳性和急性HCV感染均与精液中HCV RNA检测频率增加无关。在急性HCV和HIV合并感染的男性中，精液中检测到HCV RNA者血液标本中HCV RNA水平中位数高于精液中未检测到HCV RNA者的血液标本（P = 0.001）。35名接受随访的男性中有26名（74.3%）在≥1份样本中检测到精液HCV RNA。
急性和慢性HCV感染期间精液中均可检测到HCV RNA。这不受HIV阳性或HCV感染阶段的影响。精液中HCV RNA水平升高可能促进HCV的性传播，但包括高危行为在内的其他因素可能是HIV感染者中HCV传播的主要驱动因素。
