Zhang Jiafeng, Wang Ning, He Lin, Pan Xiaohong, Ding Xiaobei
1 Department of HIV/AIDS and STD Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou, China .
2 National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention , Beijing, China .
AIDS Res Hum Retroviruses. 2019 Apr;35(4):393-395. doi: 10.1089/AID.2018.0090. Epub 2018 Dec 26.
The alarming spread of HIV among men who have sex with men (MSM) has become a national concern in China. Estimating men's sexual HIV infectiousness from blood plasma viral load (BPVL) depends on the association between BPVL and seminal plasma viral load (SPVL). However, previous studies were controversial and few concentrated on MSM. Twenty antiretroviral therapy (ART)-naive MSM and 54 MSM under ART were recruited between July and September 2015 in the city of Hangzhou, China. Blood and semen were collected in pairs at the same visit for each individual. BPVL and SPVL were measured by COBAS AmpliPrep/COBAS TaqMan HIV-1 Test ver2.0. The mean viral load in blood plasma was higher than that in semen (4.5 ± 0.9 log vs. 3.4 ± 1.3 log) in 20 ART-untreated MSM, and a positive correlation was found between BPVL and SPVL, as evaluated by linear regression (R = 0.565, p < .001). A total of 96.3% (52/54) of ART-treated patients had successful viral suppression (<400 copies/mL) according to the BPVL. Fourteen subjects (25.9%, 14/54) presenting undetectable SPVL showed detectable BPVL, ranging from 20.4 to 7,470 copies/mL. Three subjects (5.6%, 3/54) presented detectable SPVL although BPVL was undetectable. MSM could pose a transmission risk despite undetectable BPVL. Consistent use of condoms and other risk-reduction strategies should be strongly advocated in MSM throughout all stages of HIV infection, regardless of ART.
男男性行为者（MSM）中艾滋病病毒（HIV）的惊人传播已成为中国的一个全国性问题。根据血浆病毒载量（BPVL）估算男性的性HIV传染性，取决于BPVL与精液血浆病毒载量（SPVL）之间的关联。然而，先前的研究存在争议，且很少有研究聚焦于MSM。2015年7月至9月期间，在中国杭州市招募了20名未接受抗逆转录病毒治疗（ART）的MSM和54名接受ART治疗的MSM。对每个个体在同一次就诊时成对采集血液和精液。采用COBAS AmpliPrep/COBAS TaqMan HIV-1 Test ver2.0检测BPVL和SPVL。在20名未接受ART治疗的MSM中，血浆中的平均病毒载量高于精液中的平均病毒载量（4.5±0.9 log对3.4±1.3 log），通过线性回归评估发现BPVL与SPVL之间存在正相关（R = 0.565，p < 0.001）。根据BPVL，96.3%（52/54）接受ART治疗的患者实现了病毒有效抑制（<400拷贝/毫升）。14名受试者（25.9%，14/54）精液中病毒载量检测不到，但血浆中病毒载量可检测到，范围为20.4至7470拷贝/毫升。3名受试者（5.6%，3/54）血浆中病毒载量检测不到，但精液中病毒载量可检测到。尽管血浆中病毒载量检测不到，MSM仍可能构成传播风险。无论是否接受ART治疗，在HIV感染的各个阶段，都应大力倡导MSM坚持使用避孕套和采取其他降低风险的策略。
