接受首次基于多替拉韦的 ART 方案治疗的受试者的配对血液和精液样本中 HIV-RNA 的衰减。
HIV-RNA decay in paired blood and semen samples of subjects receiving their first dolutegravir-based ART regimen.
机构信息
University of Bari 'Aldo Moro', Clinic of Infectious Diseases, Bari, Italy.
University of Bari 'Aldo Moro', Clinic of Infectious Diseases, Bari, Italy.
出版信息
J Clin Virol. 2018 Dec;109:45-49. doi: 10.1016/j.jcv.2018.11.002. Epub 2018 Nov 15.
BACKGROUND AND OBJECTIVES
We aimed to investigate to what extent a first-line DTG-based ART regimen reduces HIV-RNA in semen compared to plasma.
STUDY DESIGN
In this prospective, observational study, ART-naïve, HIV-infected males starting their first ART regimen with DTG plus TDF/FTC or ABC/3TC were enrolled. Paired blood (BP) and seminal plasma (SP) samples were collected at baseline (T0) and at week-2/4/12/24 after ART initiation. Sexually transmitted infections (STI) were ruled out before enrolment.
RESULTS
Median baseline HIV-RNA levels were lower in SP compared to BP (657 versus 38.200 copies/ml, p < 0.001), three subjects had undetectable semen HIV-RNA. After 12 weeks of treatment, HIV-RNA was below the quantification limit in both BP and SP of 11 pts (61.1%). Discordant results were obtained in 6 subjects (33.3%), showing quantifiable HIV-RNA in blood only (2 cases) and in semen only (4 cases). Finally, one subject had a positive HIV-RNA in SP/BP. At W24, only in 2/16 subjects (12.5%) HIV-RNA was detectable in semen, while in the others it was negative on SP/BP. No concurrent STI was found in subjects with detectable VL in semen.
CONCLUSIONS
DTG demonstrated effectiveness in reducing VL with different kinetics in blood and semen, despite seminal viral suppression after 6 months of ART was not obtained in the totality of subjects.
背景与目的
本研究旨在探讨一线含替诺福韦地达那韦（DTG）的抗逆转录病毒治疗（ART）方案与血浆相比，能在多大程度上降低精液中的 HIV-RNA。
研究设计
这是一项前瞻性、观察性研究，纳入了初治、感染 HIV 的男性，他们开始接受含 DTG 的一线 ART 方案治疗，方案中还包含替诺福韦/富马酸替诺福韦二吡呋酯（TDF/FTC）或阿巴卡韦/拉米夫定（ABC/3TC）。在开始 ART 前，采集基线（T0）和治疗后第 2、4、12、24 周的配对血（BP）和精液（SP）样本。在入组前排除性传播感染（STI）。
结果
SP 中的 HIV-RNA 中位基线水平低于 BP（657 比 38.200 拷贝/ml，p<0.001），有 3 例精液 HIV-RNA 不可检测。治疗 12 周后，11 例（61.1%）患者的 BP 和 SP 中 HIV-RNA 均低于定量下限。6 例（33.3%）患者出现不一致结果，仅在血液中可检测到 HIV-RNA（2 例）或仅在精液中可检测到 HIV-RNA（4 例）。最后，1 例患者的 SP 和 BP 中 HIV-RNA 均为阳性。在 W24 时，仅 2/16 例（12.5%）患者的精液中 HIV-RNA 可检测到，而其他患者的 SP 和 BP 均为阴性。在精液中可检测到 VL 的患者中未发现同时存在的 STI。
结论
DTG 显示出有效性，能降低血液和精液中的病毒载量，尽管在所有患者中，6 个月 ART 后并未获得精液中的病毒完全抑制。
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