From the Centers for Disease Control and Prevention (CDC) National Center for Emerging and Zoonotic Infectious Diseases, Fort Collins, CO (P.S.M., N.K.D., S.A.H., M.D., M.F., H.B., R.J.M., M.A., A.M.S., W.-P.T., C.A.N., E.M.M., A.C.B., A.F.H.); and the CDC National Center for Chronic Disease Prevention and Health Promotion (D.O.M.) and the CDC National Center for HIV-AIDS, Viral Hepatitis, STD, and TB Prevention (J.T.B.) - both in Atlanta.
N Engl J Med. 2018 Apr 12;378(15):1377-1385. doi: 10.1056/NEJMoa1711038.
Zika virus (ZIKV) is an emerging mosquito-borne flavivirus that has been linked to adverse birth outcomes. Previous reports have shown that person-to-person transmission can occur by means of sexual contact.
We conducted a prospective study involving men with symptomatic ZIKV infection to determine the frequency and duration of ZIKV shedding in semen and urine and to identify risk factors for prolonged shedding in these fluids. Specimens were obtained twice per month for 6 months after illness onset and were tested by real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay for ZIKV RNA and by Vero cell culture and plaque assay for infectious ZIKV.
A total of 1327 semen samples from 184 men and 1038 urine samples from 183 men were obtained 14 to 304 days after illness onset. ZIKV RNA was detected in the urine of 7 men (4%) and in the semen of 60 (33%), including in semen samples from 22 of 36 men (61%) who were tested within 30 days after illness onset. ZIKV RNA shedding in semen decreased substantially during the 3 months after illness onset but continued for 281 days in 1 man (1%). Factors that were independently associated with prolonged RNA shedding included older age, less frequent ejaculation, and the presence of certain symptoms at the time of initial illness. Infectious ZIKV was isolated from 3 of 78 semen samples with detectable ZIKV RNA, all obtained within 30 days after illness onset and all with at least 7.0 log ZIKV RNA copies per milliliter of semen.
ZIKV RNA was commonly present in the semen of men with symptomatic ZIKV infection and persisted in some men for more than 6 months. In contrast, shedding of infectious ZIKV appeared to be much less common and was limited to the first few weeks after illness onset. (Funded by the Centers for Disease Control and Prevention.).
寨卡病毒（ZIKV）是一种新兴的蚊媒黄病毒，已被证实与不良出生结局有关。先前的报告显示，人与人之间的传播可通过性接触发生。
我们进行了一项前瞻性研究，纳入了患有症状性寨卡病毒感染的男性，以确定寨卡病毒在精液和尿液中的脱落频率和持续时间，并确定这些液体中延长脱落的危险因素。在发病后 6 个月内，每月采集 2 次标本，通过实时逆转录酶聚合酶链反应（RT-PCR）检测寨卡病毒 RNA，通过vero 细胞培养和噬斑试验检测传染性寨卡病毒。
共获得 184 名男性的 1327 份精液样本和 183 名男性的 1038 份尿液样本，采集时间为发病后 14 至 304 天。7 名男性（4%）的尿液和 60 名男性（33%）的精液中检测到寨卡病毒 RNA，包括 36 名男性（61%）中 22 名在发病后 30 天内检测到的精液样本。发病后 3 个月，精液中寨卡病毒 RNA 脱落量明显减少，但 1 名男性持续脱落 281 天（1%）。与 RNA 脱落持续时间延长相关的独立因素包括年龄较大、射精频率较低以及首发疾病时存在某些症状。从 78 份可检测到寨卡病毒 RNA 的精液样本中分离出 3 份传染性寨卡病毒，均在发病后 30 天内获得，且每份精液的寨卡病毒 RNA 拷贝数至少为 7.0 log。
患有症状性寨卡病毒感染的男性的精液中通常存在寨卡病毒 RNA，并且在一些男性中持续存在超过 6 个月。相比之下，传染性寨卡病毒的脱落似乎要少见得多，并且局限于发病后最初几周。（由疾病控制和预防中心资助）。
