Human Immunodeficiency Virus Type 1 Shedding Pattern in Semen Correlates with the Compartmentalization of Viral Quasi Species Between Blood and Semen [Gupta P, et al. JID 2000; 182: 79]: The authors performed a prospective, longitudinal study of HIV RNA levels measured weekly for ten weeks in the semen and blood of 18 subjects. There were three patterns of HIV shedding in semen: none in 28%, continuous in 28%, and intermittent in 44%. By contrast, the plasma HIV RNA was consistent. The patterns of seminal viral load did not correlate with semen mononuclear cells or blood CD4 cell count. Analysis of HIV envelope sequences in semen and blood showed distinct virus populations. The authors conclude that there is compartmentalization of HIV between semen and blood, and that HIV is primarily shed in an intermittent fashion.
Comment: The authors demonstrated intermittent shedding of HIV in semen for the first time. They also noted poor correlation between levels of HIV in semen and blood. These observations emphasize the importance of standard precautions despite good response to HAART as determined by plasma HIV RNA levels. posted 8/7/2000