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PP 2.15
Correlation between circulating viral load and HIV-1 detection in the sperm of HIV-1
positive patients consulting for Medically Assisted Procreation
E.Moens, C.Liesnard, Y.Englert
C.Liesnard: Service de Virologie, Hôpital Erasme et Laboratoire de Référence SIDA de
l'ULB, 1070 Bruxelles, Belgique Y.Englert: Service de Gynécologie/Obstétrique, Hôpital
Erasme et Laboratoire de Recherche en Reproduction Humaine de l'ULB, 1070 Bruxelles,
Belgique
Objectives
Within the framework of a program for medically assisted procreation of serodiscordant
couples, we decided to analyze the factors that may predict the HIV-1 presence in the
sperm of HIV-1 positive men as well as in its various fractions.
Material and Methods
168 pairs of blood and sperm samples coming from 46 HIV-1 positive men followed for
medically assisted procreation were analyzed in parallel. The sperm of these patients and
its various fractions (seminal plasma, seminal liquid and final solution of density gradient
and swim up sperm wash) were tested by qualitative nested PCR researching for viral
RNA (detection threshold of 20 ARN HIV-1 copies per ml). The blood viral load and the
rate of CD4+ lymphocytes per mm3 of blood plasma were quantified at the time of each
sperm sampling.
Results
• The presence of HIV-1 is respectively detected in 14,6% (24/164), 19,7% (30/152) and
21,4% (34/159) of the fresh sperm, seminal plasma and seminal liquid samples as well as
in 3% (5/165) of the final sperm wash solutions. The blood viral load is detected in 42,7%
(70/164) of the cases.
• There is a blood viral load significantly higher at the time of the virus detection in the
sperm (p = 0,002), seminal plasma (p = 0,001) and seminal liquid (p = 0,002) of these
patients. Indeed, an increase in the frequency of the virus detection in the sperm and its
various fractions is observed according to the blood viremia of the patients.
• No correlation was observed between the numeration of CD4+ blood cells and the
secretion of virus in the sperm and its various fractions.
• In the same way, the rate of round cells present in sperm does not seem to affect the
frequency of virus detection taking into account a population of non-coinfected patients
(rate of round cells always in the standard).
• 3,2% (3/94) of the patients presenting a undetectable blood viremia (< 50 copies of ARN
HIV-1 per ml of blood plasma) keep identifiable virus in their sperm.
• 16,7% (4/24) of the fresh sperm samples that were detected positive at the time of the
sampling remain positive even after sperm wash. These samples come from patients with
high viral load (> 10000 copies of viral ARN per ml of blood plasma).
Conclusions
In the context of patients consulting for medically assisted procreation, the plasmatic viral
load proves to be one of the factors significantly influencing the excretion of the HIV-1 in
sperm and its various fractions. Wowever, this correlation presents exceptions reinforcing
the interest of a systematic research of the virus in the sperm before its use within the
framework of medically assisted procreation.
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