Published in the Bulletin of Experimental Treatments for AIDS 1999 Year-End issue, by the San Francisco AIDS Foundation.

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HAART and Experimental Approaches to Treatment

Anti-HIV Drug Resistance Testing

Anti-HIV Therapies Early in the Pipeline

Anti-HIV Therapy Trials: New Studies and Follow-Up of Existing Trials

New Anti-HIV Drug Interactions, Toxicities, and Dosing Options

HIV Transmission

OIs and Cancers

Year-End 1999 Table of Contents

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Conference Notes -- HIV Transmission

Harvey S. Bartnof, MD

Genital warts increase HIV viral load in semen

In a study presented at the 39th ICAAC by P.F. Barroso, MD, and colleagues from Johns Hopkins University in Baltimore, people with genital warts had a significantly higher semen viral load than those without genital warts. One hundred and three HIV positive participants had blood plasma and semen samples tested for HIV RNA viral load using the Nuclisens assay. Median CD4 cell count was 269 cells/mm³, median blood viral load was 42,000 copies/mL, and median semen viral load was 6,400 copies/mL. Eighteen (17%) of the men had genital warts-and a higher semen viral load-at the time of evaluation. In a multiple linear statistical analysis, the only significant factors associated with semen viral load were blood viral load and the presence of genital warts. Several other sexually transmitted diseases (STDs) have also been shown to raise the amount of HIV in genital fluids, which increases the risk of sexual transmission.

Genital warts are caused by the human papillomavirus (HPV). They are very common in the general population and among those with HIV infection. The warts may be quite small, even the size of a pinhead.

Lead authors L.V. Torian, MD, and M.G. Beumont, MD, presented these two studies at the 39th ICAAC. In New York men, the finding was associated with HIV infection. Rectal gonorrhea is a marker for unsafe (i.e., without a condom) receptive anal intercourse. Like many other STDs, gonorrhea increases the risk of receiving or transmitting HIV. Higher incidence of unsafe sexual behavior could foreshadow an increase in the rate of HIV transmission. In addition, newly transmitted strains are more likely to display resistance to currently available anti-HIV drugs.

This study was presented at the 39th ICAAC by S. Taylor, MD, from the University of Birmingham, England. The level of nevirapine in semen plasma (liquid portion without sperm or cells) was 60% of that in blood plasma. This level is still approximately 40-fold higher than the concentration needed to inhibit 90% of HIV strains (IC90) in the test tube. The concentration of anti-HIV drugs in genital fluids is an important issue for preventing transmission to sexual partners if safer sexual practices are not employed.

Page last updated 8 January 2000