- NEW YORK, Dec 16 (Reuters Health) -- HIV can 'hide out' in the male genital
tract, even when antiretroviral drug treatment has reduced blood levels
of the virus to undetectable levels, researchers report.
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- AIDS experts say the findings underscore
the continuing importance of condom use in reducing HIV infection rates.
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- In infected men with "no detectable
levels of viral RNA in (blood), the virus may be present in seminal cells
and therefore may be capable of being transmitted sexually,'' conclude
researchers at Thomas Jefferson University in Philadelphia, Pennsylvania.
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- Their findings, as reported by Reuters
Health from the 36th Annual Meeting of the Infectious Diseases Society
of America in Denver last month, are published in the December 17th issue
of The New England Journal of Medicine.
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- The Philadelphia team used DNA testing
to search for HIV in the blood and semen of seven infected men on highly
active antiretroviral drug therapy.
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- Although they found "no detectable''
HIV in the subject's blood samples, four of the seven men were found to
harbor an early, immature form of HIV called a 'provirus' in seminal cells.
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- Laboratory experiments revealed that
the provirus found in two of the four men were capable of developing into
viable HIV.
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- The authors speculate that provirus forms
of HIV may be sequestered in the testes during some early stage of HIV
infection. Analysis revealed that the provirus had developed little or
no resistance to antiviral drugs, suggesting that ''the genital tract can
be a reservoir for HIV-1 replication in men.''
-
- Speaking with Reuters Health at the Denver
conference, study senior author Dr. Roger Pomerantz explained that "even
if you have no viral replication in your blood or seminal fluid, there
is still latent provirus that can lead to sexual transmission.''
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- AIDS-prevention experts agree. Derek
Link, Director of Federal Affairs at Gay Men's Health Crisis in New York
City, said the study findings confirm that everyone " including HIV-positive
men responsive to treatment " "still needs to practice safe sex.''
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- "'Undetectable in the blood' does
not mean uninfectious,'' Link told Reuters Health. "People still need
to use condoms.''
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- SOURCE: The New England Journal of Medicine
1998;339:1803-1809.
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