8th Annual Conference Of The British HIV Association [BHIVA] 19 – 21 April 2002, University of York, York

[AUTHOR(S):] ST Sadiq¹, S Taylor^2,3, S Kaye², J Workman², P Cane², J Bennett¹, A Copas¹, S Drake³, I Weller¹, D Pillay
¹ Royal Free and University College Medical School, ² Public Health Laboratory Service, University of Birmingham, and ³ Birmingham Heartlands Hospital, Birmingham, UK

BHIVA Conf 2002 Apr 19-21;8:O8

OBJECTIVE: To investigate the effect of urethritis on seminal shedding of drug-resistant HIV-1 in patients receiving antiretroviral therapy.

METHODS: Viral loads (VL) were measured on blood plasma (BP) and seminal plasma (SP) samples obtained from patients on antiretroviral therapy, with and without urethritis, and 1 and 2 weeks after treatment for urethritis. Samples were analysed for genotypic resistance by reverse transcriptase polymerase chain reaction and sequencing.

RESULTS: 18/24 cases of urethritis and 13/26 controls had undetectable SP VL and BP VL at all visits. In 6/24 cases at presentation, median BP VL and SP VL were 42,457 copies/mL (range <500to 98,882) and 11,091 copies/mL (1,512–100,000), respectively. In four of these cases, a genotypic analysis of SP was possible and detected primary drug resistance associated mutations to nucleoside reverse transcriptase inhibitors (NRTIs): n=2; NRTI+protease inhibitor (PI): n=1; NRTI+NNRTI: n=1. There was minimal discordance between mutations in blood and semen. Following treatment for urethritis, SP VL was significantly reduced in three cases.

CONCLUSIONS: In men with sexually transmitted infections, multidrug resistant HIV-1 and high viral loads were detected in the semen of those on suboptimal antiretroviral therapy but not in those on effective antiretroviral therapy. These findings may have important public health implications in both the developed and developing world.

PRESENTING AUTHOR: ST Sadiq

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Copyright © 2002 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD