Eron JJ, Dyer JR, Vernazza P, Hoffman I, Fiscus S, Royce R, Kazembe P, Gilliam B, Cohen MS; University of North Carolina, Chapel Hill, NC.
We hypothesized that an increased viral inoculum in semen could be responsible for the rapidly expanding heterosexual epidemic in sub-Saharan Africa. Semen and blood were collected from 49 Malawian (MAL) and 53 US and Swiss (US-S) HIV-1 seropositive men with no clinical evidence of urethritis. All MAL subjects had become infected through heterosexual contact, while acquisition in the US-S group was by male-male sex in 30, heterosexual contact in 13, and IV drug use in 10. 94% of US-S men were Caucasian. Both groups were antiretroviral naïve. HIV-1 RNA in seminal (SP) and blood plasma (BP) was quantitated by NASBA (Organon-Teknika). CD4 counts were similar in the 2 groups. HIV-1 RNA was detectable in SP from 38/49 (78%) of Malawian men compared with 31/53 (58%) of the US-S group. Median SP and BP HIV-1 RNA concentrations were 3 and 6-fold higher respectively in the MAL men, while the ratio of BP to SP RNA did not differ significantly between the 2 groups. (Table: see text). Increased levels of HIV in semen at comparable degrees of immunodeficiency may be one factor responsible for increased heterosexual transmission in Africa.
Keywords: AEGIS, HIV-1, Semen, HIV Infections, CD4 Lymphocyte Count, HIV Seropositivity, HIV, Urethritis, Plasma, Malawi, Africa, Africa South of the Sahara, United States, Human, Male, blood, AIDS
