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National Institute for Infectious Diseases, “Lazzaro Spallanzani” IRCCS, Rome, Italy

Viral Dynamics in Plasma and Seminal Fluid among Patients Receiving Resistance Testing-guided HAART G. Liuzzi , R. Libertone, A. Amendola, F. Continenza, R. Bellagamba, S. Menichetti, P. Narciso, M.R. Capobianchi, C.F. Perno, V. Tozzi.

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National Institute for Infectious Diseases, “Lazzaro Spallanzani” IRCCS, Rome, Italy

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  1. Viral Dynamics in Plasma and Seminal Fluid among Patients Receiving Resistance Testing-guided HAARTG. Liuzzi, R. Libertone, A. Amendola, F. Continenza, R. Bellagamba, S. Menichetti, P. Narciso, M.R. Capobianchi, C.F. Perno, V. Tozzi The majority of HIV infections worldwide are acquired trough sexual contacts and the presence of HIV in semen is a critical factor for viral transmission. HAART may reduce plasma viral load (PVL) and semen viral load (SVL) to undetectable levels suggesting potential benefits for the reduction of sexual HIV transmission. We evaluated plasma viral load (PVL) and semen viral load (SVL) decay kinetics as an indicator of viral compartimentalization in male genital tract in treatment-experienced patients receiving genotypic resistance testing (GRT)-guided HAART. We prospectively assessed viral decay kinetics in 6 patients with virological failure receiving GRT-guided HAART. Parallel plasma and semen patients’ samples were collected at baseline and weekly. The rate of log cp HIV RNA changes were estimated MOPDA105 National Institute for Infectious Diseases, “Lazzaro Spallanzani” IRCCS, Rome, Italy

  2. A study over 6 patients points out a discordance between PVL and SVL trends Legenda: PATIENT = 6 observed patients TIME = weeks of observation PVL, SVL = calculated values in different weeks DPVL / DSVL = trend between 2 following weeks TREATMENT EFFECTIVENESS DPVL <vs> DSVL DISCORDANCE DISCORDANCE TREND BY WEEK acc. 4 DPVL, DSVL < 0 3 1 1 >0 2 1 DPVL, DSVL > 0 DPVL T0 T1 T2 T3 T4 1 DPVL>0, DSVL < 0 2 8 5 <0 DPVL<0, DSVL > 0 3 4 dis. <0 >0 DSVL

  3. Conclusions • Despite of the limited number of studied patients, our data indicate that, in a relevant number of observations, HIV loads in plasma and in seminal fluid may show discordant changes. • These data suggest that male genital tract could represent an anatomic or cellular compartment different from the periphery. • Viral load in semen may vary independently of plasma level, suggesting that plasma HIV RNA cannot be used to assess of the risk of HIV transmission by sexual contact

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