HIV-1 RNA levels in semen of people on ‘short-cycle’ antiretroviral therapy

Short-cycle ART, whereby virally suppressed people living with HIV (PLWH) switch to 4- or 5-days-on and 3- or 2-days-off maintenance treatment, has been shown to be a safe and effective alternative to standard daily treatment in a randomized clinical trial1 and other small, not randomized, studies.2,3 Pharmacokinetic analyses showed low or undetectable plasma drug levels in the ‘off’ period in some participants, without virological failure.2 –4 PLWH on daily ART with suppressed plasma HIV RNA are advised that they can have unprotected sexual intercourse without transmitting the virus.5 Recently, the ANRS 170 Quatour study group published results on semen HIV RNA amount in 78 participants6 of the 4 days/week maintenance strategy study.1 Their results supported that short-cycle therapy is effective in controlling genital HIV shedding. We evaluated HIV RNA levels in the seminal fluid of seven virologically suppressed PLWH (all male) on different short-cycle antiretroviral regimens. In Table1 we reported the antiretroviral regimen for each patient and the month and year of start of short-cycle therapy. They had been on ART for a mean of 13 years (range 3 –26 years) before starting short-cycle therapy. At the time of sample collection, four patients were taking ART from Monday to Thursday and three from Monday to Friday. Semen samples (collected through masturbation) and blood samples were collected on Monday, the day after the off period, 1 to 12 h before pill’s oral in...
Source: Journal of Antimicrobial Chemotherapy - Category: Microbiology Source Type: research