HIV Can Hide In Male Genital Tract - Even Though Blood Is Clear
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.
AIDS experts say the findings underscore the continuing importance of condom use in reducing HIV infection rates.
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.
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.
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.
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.
Laboratory experiments revealed that the provirus found in two of the four men were capable of developing into viable HIV.
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.''
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.''
"'Undetectable in the blood' does not mean uninfectious,'' Link told Reuters Health. "People still need to use condoms.''
SOURCE: The New England Journal of Medicine 1998;339:1803-1809.