Department of Clinical Sciences, Institute of Tropical Medicine, Kronenburgstraat 43/3, B-2000, Antwerp, Belgium.
Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
Bull World Health Organ. 2017 Dec 1;95(12):802-809. doi: 10.2471/BLT.17.181370. Epub 2017 Jul 6.
To prospectively monitor Zika viral loads in semen from Belgian travellers with confirmed Zika virus infection, who returned from the Americas during the 2016 Zika virus epidemic.
We recruited symptomatic travellers consulting our clinic and we confirmed infection with either reverse-transcriptase (RT) polymerase chain reaction (PCR) assay or virus neutralization test. The participants produced semen samples weekly, either at the clinic or at home. For the initial sample, the laboratory staff did a microscopy analysis if they received the sample within an hour of production. Using RT-PCR, we monitored Zika virus ribonucleic acid (RNA) loads in semen until we obtained two negative results.
We detected Zika virus RNA in nine of 15 participants' semen, one of whom was vasectomized. The median time to loss of RNA detection in semen was 83 days after symptom onset (95% confidence interval, CI: 57-108). The longest duration of viral shedding in semen before obtaining the first negative RT-PCR result was 144 days after symptom onset. All of the 11 participants, for whom we microscopically analysed their semen, had presence of leukocytes, 10 showed haematospermia and six showed oligospermia. These abnormalities occurred irrespective of Zika virus detection in semen.
The majority of men in our study had detectable Zika virus RNA in their semen. We recommend that semen from Zika virus-infected men should be analysed with RT-PCR and that health professionals should advise infected men, even if they are vasectomized, about current recommendations for prevention of sexual transmission of the virus.
前瞻性监测 2016 年寨卡病毒流行期间从美洲返回的比利时旅行者中确诊寨卡病毒感染患者精液中的寨卡病毒载量。
我们招募了出现症状并在我们诊所就诊的旅行者，并通过逆转录酶（RT）聚合酶链反应（PCR）检测或病毒中和试验来确认感染。参与者每周在家或在诊所采集精液样本。对于初始样本，如果在样本产生后 1 小时内收到，实验室工作人员会进行显微镜分析。使用 RT-PCR，我们监测精液中寨卡病毒核糖核酸（RNA）载量，直到获得两个阴性结果。
我们在 15 名参与者的精液中检测到 9 名参与者的寨卡病毒 RNA，其中 1 名接受者已行输精管结扎术。症状出现后 83 天（95%置信区间，CI：57-108）精液中 RNA 检测消失的中位数时间。获得第一个阴性 RT-PCR 结果之前，精液中病毒最长的排出时间为症状出现后 144 天。我们对精液进行了显微镜分析的 11 名参与者中，均存在白细胞，10 名出现血精，6 名出现少精症。这些异常与精液中寨卡病毒的检测无关。
我们研究中的大多数男性精液中可检测到寨卡病毒 RNA。我们建议用 RT-PCR 分析寨卡病毒感染男性的精液，并且卫生专业人员应该告知感染的男性，即使他们已行输精管结扎术，也要遵守目前关于预防病毒性传播的建议。
