HIV-RNA decay in paired blood and semen samples of subjects receiving their first dolutegravir-based ART regimen.

HIV-RNA decay in paired blood and semen samples of subjects receiving their first dolutegravir-based ART regimen.

J Clin Virol. 2018 Nov 15;109:45-49

Authors: Fabrizio C, de Gennaro N, Volpe A, Scudeller L, Lagioia A, Falasca K, Ladisa N, Angarano G, Monno L, Saracino A

Abstract
BACKGROUND AND OBJECTIVES: We aimed to investigate to what extent a first-line DTG-based ART regimen reduces HIV-RNA in semen compared to plasma.
STUDY DESIGN: In this prospective, observational study, ART-naïve, HIV-infected males starting their first ART regimen with DTG plus TDF/FTC or ABC/3TC were enrolled. Paired blood (BP) and seminal plasma (SP) samples were collected at baseline (T0) and at week-2/4/12/24 after ART initiation. Sexually transmitted infections (STI) were ruled out before enrolment.
RESULTS: Median baseline HIV-RNA levels were lower in SP compared to BP (657 versus 38.200 copies/ml, p < 0.001), three subjects had undetectable semen HIV-RNA. After 12 weeks of treatment, HIV-RNA was below the quantification limit in both BP and SP of 11 pts (61.1%). Discordant results were obtained in 6 subjects (33.3%), showing quantifiable HIV-RNA in blood only (2 cases) and in semen only (4 cases). Finally, one subject had a positive HIV-RNA in SP/BP. At W24, only in 2/16 subjects (12.5%) HIV-RNA was detectable in semen, while in the others it was negative on SP/BP. No concurrent STI was found in subjects with detectable VL in semen.
CONCLUSIONS: DTG demonstrated effectiveness in reducing VL with different kinetics in blood and semen, despite seminal viral suppression after 6 months of ART was not obtained in the totality of subjects.

PMID: 30471517 [PubMed - as supplied by publisher]

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