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

• Published in: Journal of clinical virology Vol. 109; pp. 45 - 49
• Main Authors: Fabrizio, Claudia, de Gennaro, Nicolò, Volpe, Anna, Scudeller, Luigia, Lagioia, Antonella, Falasca, Katia, Ladisa, Nicoletta, Angarano, Gioacchino, Monno, Laura, Saracino, Annalisa
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.12.2018
• Subjects: Antiretroviral therapy; Dolutegravir; HIV; Semen; Sexual transmission; Sexual transmission; HIV; Semen; Antiretroviral therapy; Dolutegravir
• ISSN: 1386-6532; 1873-5967; 1873-5967
• DOI: 10.1016/j.jcv.2018.11.002

•Dolutegravir suppressed HIV-RNA within the first 6 months of ART in naïve subjects.•A biphasic viral load decrease was observed in plasmatic and seminal compartments.•HIV-RNA decay was significantly faster in blood than in semen.•HIV-RNA seminal shedding was not related with clinical/viro-immunological features. We aimed to investigate to what extent a first-line DTG-based ART regimen reduces HIV-RNA in semen compared to plasma. 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. 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. 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.