Vasectomy and human immunodeficiency virus type 1 in semen
Vasectomy and human immunodeficiency virus type 1 in semen
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DOI：
10.1016/s0022-5347(01)63742-x
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发表时间：
1998-03-01
影响因子：
6.6
通讯作者：
Coombs, RW
中科院分区：
文献类型：
--
作者：
Krieger, JN;Nirapathpongporn, A;Coombs, RW
目的：人类免疫缺陷病毒1型（HIV）更常从精细胞培养而不是精浆。由于输精管结扎术导致精液细胞的显著减少，并且还消除了男性生殖道近端部位的分泌物，因此输精管结扎术可能改变精液的潜在感染性。我们采用聚合酶链反应（PCR）检测了46例无症状、血清学阳性男性输精管切除术前后精浆中HIV核糖核酸（RNA）和精浆细胞中HIV脱氧核糖核酸（DNA）。精液中的HIV RNA水平与血液中的HIV RNA水平仅弱相关（r = 0.22，p = 0.03）。在183份精液标本中，37份（20%）仅HIV RNA阳性，41份（22%）仅HIV DNA阳性，18份（10%）RNA和DNA均阳性。因此，精浆中HIV RNA的检测与精细胞中HIV DNA的检测无关。82份标本中有23份（28%）存在HIV RNA（平均2.87 log拷贝/ml）。121例标本中38例（31%）在输精管结扎前和输精管结扎后均为阳性（平均2.81 log copies/ml）。结论.这些研究结果表明，直接测量精液中的艾滋病毒水平对于评估性传播的可能性是必要的，精浆中的大多数无细胞艾滋病毒产生于输精管远端，输精管切除术对艾滋病毒血清阳性男性的传染性影响可能很小对性伴侣。
Purpose: Human immunodeficiency virus type 1 (HIV) is cultured more often from seminal cells than seminal plasma. Because vasectomy causes dramatic reductions in seminal cells and also eliminates secretions from proximal sites in the male reproductive tract, vasectomy may change the potential infectiousness of semen.Materials and Methods. We used polymerase chain reaction (PCR) assays to measure HIV ribonucleic acid (RNA) in seminal plasma and HIV deoxyribonucleic acid (DNA) in seminal cells from 46 asymptomatic, seropositive men before and after vasectomy.Results. HIV RNA levels in semen correlated only weakly with blood levels (r = 0.22, p = 0.03). Of 183 semen specimens assayed for cell-free HIV RNA and proviral DNA 37 (20%) were positive for HIV RNA only, 41 (22%) were positive for HIV DNA only, and 18 (10%) were positive for RNA and DNA. Thus, detection of HIV RNA in seminal plasma was not associated with detection of HIV DNA in seminal cells. HIV RNA was present in 23 of 82 specimens (28%) (mean 2.87 log copies/ml.) before vasectomy and in 38 of 121 specimens (31%) after vasectomy (mean 2.81 log copies/ml.).Conclusions. These findings suggest that direct measurement of HIV levels in semen is necessary to assess the potential for sexual transmission, most cell-free HIV in seminal plasma arises distal to the vas deferens, and vasectomy may have minimal impact on the infectiousness of HIV seropositive men on sexual partners.