Krieger J N, Nirapathpongporn A, Chaiyaporn M, Peterson G, Nikolaeva I, Akridge R, Ross S O, Coombs R W
Department of Urology, University of Washington School of Medicine, Seattle, USA.
J Urol. 1998 Mar;159(3):820-5; discussion 825-6.
Human immunodeficiency virus type 1 (HIV) is cultured more often from seminal cells than seminal plasma. Because vasectomy causes dramatic reductions in seminal cells and also eliminates secretions from proximal sites in the male reproductive tract, vasectomy may change the potential infectiousness of semen.
We used polymerase chain reaction (PCR) assays to measure HIV ribonucleic acid (RNA) in seminal plasma and HIV deoxyribonucleic acid (DNA) in seminal cells from 46 asymptomatic, seropositive men before and after vasectomy.
HIV RNA levels in semen correlated only weakly with blood levels (r = 0.22, p = 0.03). Of 183 semen specimens assayed for cell-free HIV RNA and proviral DNA 37 (20%) were positive for HIV RNA only, 41 (22%) were positive for HIV DNA only, and 18 (10%) were positive for RNA and DNA. Thus, detection of HIV RNA in seminal plasma was not associated with detection of HIV DNA in seminal cells. HIV RNA was present in 23 of 82 specimens (28%) (mean 2.87 log copies/ml.) before vasectomy and in 38 of 121 specimens (31%) after vasectomy (mean 2.81 log copies/ml.).
These findings suggest that direct measurement of HIV levels in semen is necessary to assess the potential for sexual transmission, most cell-free HIV in seminal plasma arises distal to the vas deferens, and vasectomy may have minimal impact on the infectiousness of HIV seropositive men on sexual partners.
1型人类免疫缺陷病毒（HIV）在精液细胞中的培养频率高于精浆。由于输精管结扎会导致精液细胞显著减少，还会消除男性生殖道近端部位的分泌物，因此输精管结扎可能会改变精液的潜在传染性。
我们使用聚合酶链反应（PCR）检测法，对46名无症状血清阳性男性在输精管结扎前后的精浆中的HIV核糖核酸（RNA）和精液细胞中的HIV脱氧核糖核酸（DNA）进行测量。
精液中的HIV RNA水平与血液水平仅存在微弱相关性（r = 0.22，p = 0.03）。在检测无细胞HIV RNA和前病毒DNA的183份精液标本中，37份（20%）仅HIV RNA呈阳性，41份（22%）仅HIV DNA呈阳性，18份（10%）RNA和DNA均呈阳性。因此，精浆中HIV RNA的检测与精液细胞中HIV DNA的检测无关。输精管结扎前，82份标本中有23份（28%）存在HIV RNA（平均2.87 log拷贝/ml），输精管结扎后，121份标本中有38份（31%）存在HIV RNA（平均2.81 log拷贝/ml）。
这些发现表明，直接测量精液中的HIV水平对于评估性传播潜力是必要的，精浆中大多数无细胞HIV产生于输精管远端，输精管结扎对HIV血清阳性男性对性伴侣的传染性可能影响极小。
