HIV-1 RNA may decline more slowly in semen than in blood following initiation of efavirenz-based antiretroviral therapy.
HIV-1 RNA may decline more slowly in semen than in blood following initiation of efavirenz-based antiretroviral therapy.
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DOI：
10.1371/journal.pone.0043086
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Coombs RW
中科院分区：
文献类型：
--
作者：
Graham SM;Holte SE;Dragavon JA;Ramko KM;Mandaliya KN;McClelland RS;Peshu NM;Sanders EJ;Krieger JN;Coombs RW
抗逆转录病毒疗法（ART）可降低精液中的HIV-1 RNA水平，并减少HIV-1感染男性的性传播。我们的目的是研究在13名未接受过抗逆转录病毒治疗的肯尼亚男性中，在开始以依法韦仑为基础的ART治疗后，精液HIV-1 RNA衰变的时间进程和幅度。在基线和ART治疗的第一个月内定量血液和精液中的HIV-1 RNA（检测下限，120拷贝/mL）。使用Wilcoxon符号秩检验比较每个时间点的中位log 10 HIV-1 RNA。Perelson的两阶段病毒衰减模型和非线性随机效应被用来比较血液和精液中的衰减率。血液中HIV-1 RNA的基线中位数为4.40 log 10拷贝/mL（范围，3.20-5.08 log 10拷贝/mL），精液中为3.69 log 10拷贝/mL（范围，<2.08-4.90 log 10拷贝/mL）。到第28天，血液中HIV-1 RNA的中位降幅为1.90 log 10拷贝/mL（范围：0.56-2.68 log 10拷贝/mL），精液中为1.36 log 10拷贝/mL（范围：0-2.66 log 10拷贝/mL）。ART导致血液和精液在第7天和第14天较基线降低（分别为p= 0.005和p =0.006）。 精液中的初始建模衰减速率比血液中慢（p = 0.06）。 血液和精液的第二阶段衰变率没有差异。基于依法韦仑的ART降低精液中HIV-1 RNA水平的速度比血液中慢。虽然这种差异在这项小型研究中具有边缘意义，但我们的观察结果表明，在治疗的最初几周，一些男性的精液HIV-1 RNA受到了次优抑制。
Antiretroviral therapy (ART) decreases HIV-1 RNA levels in semen and reduces sexual transmission from HIV-1-infected men. Our objective was to study the time course and magnitude of seminal HIV-1 RNA decay after initiation of efavirenz-based ART among 13 antiretroviral-naïve Kenyan men. HIV-1 RNA was quantified (lower limit of detection, 120 copies/mL) in blood and semen at baseline and over the first month of ART. Median log10 HIV-1 RNA was compared at each time-point using Wilcoxon Signed Rank tests. Perelson’s two-phase viral decay model and nonlinear random effects were used to compare decay rates in blood and semen. Median baseline HIV-1 RNA was 4.40 log10 copies/mL in blood (range, 3.20–5.08 log10 copies/mL) and 3.69 log10 copies/mL in semen (range, <2.08–4.90 log10 copies/mL). The median reduction in HIV-1 RNA by day 28 was 1.90 log10 copies/mL in blood (range, 0.56–2.68 log10 copies/mL) and 1.36 log10 copies/mL in semen (range, 0–2.66 log10 copies/mL). ART led to a decrease from baseline by day 7 in blood and day 14 in semen (p = 0.005 and p = 0.006, respectively). The initial modeled decay rate was slower in semen than in blood (p = 0.06). There was no difference in second-phase decay rates between blood and semen. Efavirenz-based ART reduced HIV-1 RNA levels more slowly in semen than in blood. Although this difference was of borderline significance in this small study, our observations suggest that there is suboptimal suppression of seminal HIV-1 RNA for some men in the early weeks of treatment.
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影响因子：
17.1
作者：
Baeten JM;Kahle E;Lingappa JR;Coombs RW;Delany-Moretlwe S;Nakku-Joloba E;Mugo NR;Wald A;Corey L;Donnell D;Campbell MS;Mullins JI;Celum C;Partners in Prevention HSV/HIV Transmission Study Team
通讯作者：
Partners in Prevention HSV/HIV Transmission Study Team
影响因子：
11.8
作者：
Ivers, LC;Kendrick, D;Doucette, K
通讯作者：
Doucette, K
影响因子：
3
作者：
Lorello, G.;la Porte, C.;MacPherson, P.
通讯作者：
MacPherson, P.
影响因子：
6.4
作者：
Reddy, YS;Gotzkowsky, SK;Kashuba, ADM
通讯作者：
Kashuba, ADM
影响因子：
3.8
作者：
Ghosn, J;Chaix, ML;Rouzioux, C
通讯作者：
Rouzioux, C