Effect of Antiretroviral Therapy on HIV Shedding in Semen

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Abstract
The effect of antiretroviral therapy on seminal HIV shedding in the community remains unknown. To evaluate the effect of antiretroviral therapy on HIV shedding in semen. Prospective cohort study. University hospital in Rio de Janeiro, Brazil. 93 HIV-infected men. Antiretroviral therapy as prescribed by each patient's physician. HIV RNA in semen and blood plasma before and after introduction of therapy. At baseline, HIV RNA was detected in 69 semen samples (74%) and 89 blood samples (96%). Six months after introduction of therapy, HIV RNA was detected in 29 semen samples (33%) and 33 blood samples (38%). The mean reduction in levels of HIV RNA in semen at 6 months was 1.65 log10 units. Antiretroviral therapy reduces shedding of HIV in semen, which probably in turn reduces HIV transmissibility. However, a substantial proportion of patients may still be infectious and may have drug-resistant strains of the virus.