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Risk factors for HIV-1 shedding in semen. 
AMERICAN JOURNAL OF EPIDEMIOLOGY, vol. 150, n° 6, 1999, pages 622-631, 56 réf., ISSN 0002-9262, USA
SPECK (C.E.), COOMBS (R.W.), KOUTSKY (L.A.), ZEH (J.), ROSS (S.O.), HOOTON (T.M.), COLLIER (A.C.), COREY (L.), CENT (A.), DRAGAVON (J.), LEE (W.), JOHNSON (E.J.), SAMPOLEO (R.R.), KRIEGER (J.N.)
Department of Epidemiology. University of Washington. Seattle. WA. USA, Department of Laboratory Medicine. University of Washington. Seattle. WA. USA, Department of Medicine. University of Washington. Seattle. WA. USA, Department of Urology. University of Washington. Seattle. WA. USA
Semen is the body fluid most commonly associated with sexual transmission of human immunodeficiency virus type-1 (HIV-1).
Because the male genitourinary tract is distinct immunologically from blood, compartment-dependent factors may determine HIV-1 shedding in semen.
To identify these factors, the authors obtained 411 semen and blood specimens from 149 men seen up to three times.
Seminal plasma was assayed for HIV-RNA and semen was cocultured for HIV-1 and cytomegalovirus (CMV), which may up-regulate HIV-1 replication.
The best multivariate model for predicting a positive semen HIV-1 coculture included two local urogenital factors, increased seminal polymorphonuclear cell count (odds ratio (OR)=12.6 for each log10 increase/mL, 95% confidence interval (Cl) 12.2,134.5) and a positive CMV coculture (OR=3.0,95% Cl 1.2,7.7).
The best multivariate model for predicting semen HIV-1 RNA included two systemic host factors, CD4+cell counts<200/muliter (OR=3.0,95 percent Cl 1.3,6.9) and nucleoside antiretroviral therapy (monotherapy : OR=0.5,95% CI 0.3,1.0 ; combination therapy : OR=0.4,95% CI 0.2,0.9), and a positive CMV coculture (OR=1.7,95% Cl 1.0,3.0).
Thus, both systemic and local genitourinary tract factors influence the risk of semen HIV-1 shedding.
These findings suggest that measures of systemic virus burden alone may not predict semen infectivity reliably.
Mots-clés BDSP : Sida, Virose, Infection, VIH, Rétrovirus, Virus, Sang, Epidémiologie, Facteur risque, Homme, Etats Unis, Amérique, Immunopathologie, Appareil génital mâle, Amérique du Nord
Mots-clés Pascal : SIDA, Virose, Infection, Virus HIV1, Virus immunodéficience humaine, Lentivirus, Retroviridae, Virus, Cytomegalovirus humain, Betaherpesvirinae, Herpesviridae, Réaction chaîne polymérase, Biologie moléculaire, Liquide séminal, Sang, Culture cellulaire, Epidémiologie, Technique, Détection, Facteur risque, Homme, Mâle, Etats Unis, Amérique du Nord, Amérique, Immunopathologie, Immunodéficit, Appareil génital mâle
Mots-clés Pascal anglais : AIDS, Viral disease, Infection, HIV-1 virus, Human immunodeficiency virus, Lentivirus, Retroviridae, Virus, Human cytomegalovirus, Betaherpesvirinae, Herpesviridae, Polymerase chain reaction, Molecular biology, Seminal plasma, Blood, Cell culture, Epidemiology, Technique, Detection, Risk factor, Human, Male, United States, North America, America, Immunopathology, Immune deficiency, Male genital system
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