Factors Associated with Increased Levels of Human Immunodeficiency Virus Type 1 DNA in Semen

Human immunodeficiency virus type 1 (HIV-1)–infected cells have been isolated from semen and may be a major source of transmissible virus. Quantitative polymerase chain reaction (PCR) assay was used to determine HIV proviral DNA load in cellular fractions of semen from 74 antiviral therapy–naive HIV-1–seropositive men and 53 paired blood samples. HIV-1 DNA was detected in 65 % of semen (range: 10–5000 copies/mL) and 100 % of blood samples (range: 20–2500 copies/ mL). HIV-1 DNA copy numbers in semen correlated significantly with those in blood, but for most cases, the concentration of blood HIV-1 DNA was higher (mean blood-to-semen ratio 2.9). Factors associated with elevated HIV-1 provirus levels in semen included reduced peripheral CD4 cell count and asymptomatic genital tract inflammation (106 white blood cells/mL of semen). These data provide evidence that genital tract inflammation and reduced peripheral CD4 cell count may be associated with enhanced sexual transmission of HIV-1 because of increased numbers of HIV-1– infected cells in semen. Human immunodeficiency virus type 1 (HIV-1) has been Mounting evidence suggests that HIV-1–infected cells in semen play a role in the sexual transmission of HIV-1. Virusdetected in semen by culture [1–3] and, more recently, by polymerase chain reaction (PCR) techniques [4, 5]. Sexual con- is more commonly cultured from the cellular fraction of seme