| Titre : | Risk factors for HIV-1 shedding in semen. (1999) |
| Auteurs : | C.E. SPECK ; A. CENT ; A.C. Collier ; R.W. COOMBS ; L. COREY ; J. DRAGAVON ; T.M. HOOTON ; E.J. JOHNSON ; L.A. KOUTSKY ; J.N. KRIEGER ; W. LEE ; S.O. ROSS ; R.R. SAMPOLEO ; J. ZEH ; Department of Epidemiology. University of Washington. Seattle. WA. USA ; Department of Laboratory Medicine. University of Washington. Seattle. WA. USA ; Department of Medicine. University of Washington. Seattle. WA. USA ; Department of Urology. University of Washington. Seattle. WA. USA |
| Type de document : | Article |
| Dans : | American journal of epidemiology (vol. 150, n° 6, 1999) |
| Pagination : | 622-631 |
| Langues: | Anglais |
| Mots-clés : | Sida ; Virose ; Infection ; VIH ; Rétrovirus ; Virus ; Sang ; Epidémiologie ; Facteur risque ; Homme ; Etats Unis ; Amérique ; Immunopathologie ; Appareil génital mâle ; Amérique du Nord |
| Résumé : | [BDSP. Notice produite par INIST R0xRjmD7. Diffusion soumise à autorisation]. Semen is the body fluid most commonly associated with sexual transmission of human immunodeficiency virus type-1 (HIV-1). Because the male genitourinary tract is distinct immunologically from blood, compartment-dependent factors may determine HIV-1 shedding in semen. To identify these factors, the authors obtained 411 semen and blood specimens from 149 men seen up to three times. Seminal plasma was assayed for HIV-RNA and semen was cocultured for HIV-1 and cytomegalovirus (CMV), which may up-regulate HIV-1 replication. The best multivariate model for predicting a positive semen HIV-1 coculture included two local urogenital factors, increased seminal polymorphonuclear cell count (odds ratio (OR)=12.6 for each log10 increase/mL, 95% confidence interval (Cl) 12.2,134.5) and a positive CMV coculture (OR=3.0,95% Cl 1.2,7.7). The best multivariate model for predicting semen HIV-1 RNA included two systemic host factors, CD4+cell counts<200/muliter (OR=3.0,95 percent Cl 1.3,6.9) and nucleoside antiretroviral therapy (monotherapy : OR=0.5,95% CI 0.3,1.0 ; combination therapy : OR=0.4,95% CI 0.2,0.9), and a positive CMV coculture (OR=1.7,95% Cl 1.0,3.0). Thus, both systemic and local genitourinary tract factors influence the risk of semen HIV-1 shedding. These findings suggest that measures of systemic virus burden alone may not predict semen infectivity reliably. |
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