Journal ArticleDOI
Effect of antiviral treatment on the shedding of HIV-1 in semen.
Pietro Vernazza,Bruce L. Gilliam,Markus Flepp,John R. Dyer,Andreas C. Frank,Susan A. Fiscus,Myron S. Cohen,Joseph J. Eron +7 more
Reads0
Chats0
TLDR
Treatment-induced changes of HIV RNA concentration in blood are generally associated with a corresponding change in seminal HIV RNA, and potent antiretroviral therapy might reduce the spread of HIV-1.Abstract:
Objective: The potential role of antiretroviral treatment on the infectiousness of HIV1-infected men was examined by studying the effect of antiviral treatment on the shedding of HIV-1 in semen. Methods: Forty-four patients enrolled in various treatment protocols were asked to donate a semen sample before they began a new antiviral treatment and at a followup visit after 6 to 15 weeks of treatment. Since most patients were on blinded protocols, patients were stratified by response of blood viral load. The effect of each patient’s treatment was classified as good (n = 24), fair (n = 8) and marginal (n = 13) by measurement of the HIV RNA reduction in blood plasma (> 1.0 log10; 0.5‐1.0 log 10 and <0.5 log 10 HIV RNA copies/ml reduction, respectively). The effect of treatment on shedding of HIV-1 in semen was documented by the reduction of HIV RNA concentration in seminal plasma and by quantitative HIV-1 seminal cell culture. Results: Overall, antiviral treatment resulted in a significant fall in the viral load in semen (RNA and culture) that paralleled the reduction of viral load in blood. More pronounced reductions of HIV RNA in semen were observed as the effectiveness of treatment on blood HIV RNA levels increased (median drop from baseline 0, 0.3 log 10 and 0.8 log 10 RNA copies/ml in patients with marginal, fair and good treatment effect, respectively). Thirteen patients lost detectable HIV RNA in blood on treatment and all of these had undetectable levels of HIV-1 in semen by culture and RNA analysis at follow-up. In 19 of the 31 patients (62%) who still had HIV RNA in their blood during treatment, semen HIV levels were below detection in semen at follow-up. Conclusions: Treatment-induced changes of HIV RNA concentration in blood are generally associated with a corresponding change in seminal HIV RNA. If confirmed in larger studies, potent antiretroviral therapy might reduce the spread of HIV-1.read more
Citations
More filters
Journal ArticleDOI
Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs.
TL;DR: The prevalence of high-risk sexual behavior is reduced substantially after people become aware they are HIV+.
Journal ArticleDOI
Association of highly active antiretroviral therapy coverage, population viral load, and yearly new HIV diagnoses in British Columbia, Canada: a population-based study
Julio S. G. Montaner,Julio S. G. Montaner,Julio S. G. Montaner,Viviane D. Lima,Viviane D. Lima,Rolando Barrios,Benita Yip,Evan Wood,Evan Wood,Thomas Kerr,Thomas Kerr,Kate Shannon,Kate Shannon,P. Richard Harrigan,P. Richard Harrigan,Robert S. Hogg,Robert S. Hogg,Patricia Daly,Perry Kendall +18 more
TL;DR: A population-level association between increasing HAART coverage, decreased viral load, and decreased number of new HIV diagnoses per year is shown, which supports the proposed secondary benefit of HAART used within existing medical guidelines to reduce HIV transmission.
Journal ArticleDOI
The case for expanding access to highly active antiretroviral therapy to curb the growth of the HIV epidemic
Julio S. G. Montaner,Robert S. Hogg,Evan Wood,Thomas Kerr,Mark W. Tyndall,Adrian R. Levy,P. Richard Harrigan +6 more
TL;DR: The potential role of HAART in HIV prevention and the resulting impact this would have on the cost-eff ectiveness of the treatment are examined.
Journal ArticleDOI
Barriers to Use of Free Antiretroviral Therapy in Injection Drug Users
Steffanie A. Strathdee,Anita Palepu,Peter G. A. Cornelisse,Benita Yip,Michael V. O'Shaughnessy,Julio S. G. Montaner,Martin T. Schechter,Robert S. Hogg +7 more
TL;DR: Despite free antiretroviral therapy, many HIV-infected injection drug users are not receiving it and public health efforts should target younger and female drug users, and physicians with less experience treating HIV infection.
Journal ArticleDOI
Public health implications of antiretroviral therapy and HIV drug resistance.
TL;DR: Unless this topic is appropriately addressed, the likelihood is that drug-resistant variants of HIV, if able to successfully replicate, will sustain the epidemic and limit the effectiveness of antiviral therapy.
References
More filters
Book
Infectious Diseases of Humans: Dynamics and Control
Roy M. Anderson,Robert M. May +1 more
TL;DR: This book discusses the biology of host-microparasite associations, dynamics of acquired immunity heterogeneity within the human community indirectly transmitted helminths, and the ecology and genetics of hosts and parasites.
Journal ArticleDOI
Impact of improved treatment of sexually transmitted diseases on HIV infection in rural Tanzania: randomised controlled trial
Heiner Grosskurth,Jim Todd,Ezra Mwijarubi,Philippe Mayaud,A. Nicoll,G Ka-Gina,J. Newell,Denise Mabey,Richard J. Hayes,Frank Mosha,Kesheni P. Senkoro,John Changalucha,Klokke Ah,Kokungoza Mugeye +13 more
TL;DR: It is concluded that improved STD treatment reduced HIV incidence by about 40% in this rural population of Tanzania, the first randomised trial to demonstrate an impact of a preventive intervention on HIV incidence in a general population.
Journal ArticleDOI
Sexual transmission of HIV
TL;DR: The epidemiology and biology of the host-related factors that affect the sexual transmission of HIV and the host susceptibility and infectiousness environment biologic agent are discussed.
Journal ArticleDOI
Antiretroviral Therapy for HIV Infection in 1998: Updated Recommendations of the International AIDS Society–USA Panel
Charles C. J. Carpenter,Margaret A. Fischl,Scott M. Hammer,Martin S. Hirsch,Donna M. Jacobsen,David Katzenstein,Julio S. G. Montaner,Douglas D. Richman,Michael S. Saag,Robert T. Schooley,Melanie A. Thompson,Stefano Vella,Patrick Yeni,Paul A. Volberding +13 more
TL;DR: New data have provided a stronger rationale for earlier initiation of more aggressive therapy than previously recommended and reinforce the importance of careful selection of initial drug regimen for each patient for optimal long-term clinical benefit and adherence.
Journal ArticleDOI
Reduction of concentration of HIV-1 in semen after treatment of urethritis: implications for prevention of sexual transmission of HIV-1
Myron S. Cohen,Irving F. Hoffman,Rachel A. Royce,Peter N. Kazembe,John R. Dyer,Celine Costello Daly,Dick Zimba,Pietro Vernazza,Martin Maida,Susan A. Fiscus,Joseph J. Eron +10 more
TL;DR: HIV-1-control programmes, which include detection and treatment of STDs in patients already infected with HIV-1, may help to curb the epidemic and targeting of gonococcal urethritis may be a particularly effective strategy.