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Effect of Antiretroviral Therapy on HIV Shedding in Semen

Paulo F. Barroso, MD, PhD; Mauro Schechter, MD, PhD; Phalguni Gupta, PhD; Maria F. Melo, BS; Marcello Vieira, MD; Fernanda C. Murta, RN; Yeda Souza; and Lee H. Harrison, MD
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Copyright ©2004 by the American College of Physicians

Ann Intern Med. 2000;133(4):280-284. doi:10.7326/0003-4819-133-4-200008150-00012
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Background: The effect of antiretroviral therapy on seminal HIV shedding in the community remains unknown.

Objective: To evaluate the effect of antiretroviral therapy on HIV shedding in semen.

Design: Prospective cohort study.

Setting: University hospital in Rio de Janeiro, Brazil.

Patients: 93 HIV-infected men.

Intervention: Antiretroviral therapy as prescribed by each patient's physician.

Measurement: HIV RNA in semen and blood plasma before and after introduction of therapy.

Results: 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.

Conclusions: 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.


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Patients with detectable HIV viral load(> 400 copies/mL) in semen (top) and blood plasma (bottom) before and after introduction of antiretroviral therapy.
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Summary for Patients

The Effect of Anti-HIV Drugs on the Amount of HIV in Semen

Copyright ©2004 by the American College of Physicians


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