HUMAN-IMMUNODEFICIENCY-VIRUS LOAD - QUANTITATIVE ASSESSMENT IN SEMEN FROM SEROPOSITIVE INDIVIDUALS AND IN SPIKED SEMINAL PLASMA

OBJECTIVE: To establish criteria for the quantitation of the human imm unodeficiency virus (HN) in seminal plasma, seminal cells and the whol e semen of HIV-infected individuals. The re verse transcription polyme rase chain reaction (RT-PCR), DNA-PCR and semen HIV culture assays wer e standardized by testing seminal plasma spiked separately with serial dilutions of cell-free and cell-associated HN stocks of known titers. The standardized assays were then used to assess the quantity of viru s in the freshly collected seminal cells and seminal plasma. RESULTS: Analysis of freshly collected peripheral blood mononuclear cells (PBMC s) and paired semen from HIV-seropositive men who had received antivir al drugs and/or immunemodulators indicated that HIV could be isolated from 42 of 55 (76%) samples of peripheral blood mononuclear cells (PBM Cs) and 13 of 55 (24%) samples of ejaculates. Since no semen sample to ns culture positive in the absence of culturable HIV in PBMCs of the s ame individual, RT-PCR was 5-125 times more sensitive than cell cultur es for the quantitation of HIV spiked in seminal plasma, freshly colle cted seminal fluid and whole semen. Further, HIV-RNA teas detected in samples containing higher dilutions of-virus from which HIV wits not i solated by culture. CONCLUSION: We conclude that cell-free HIV is pres ent in excess of the culturable virus in all specimens tested and that the high sensitivity of HIV-RNA detection is useful for quantitation of the virus directly in seminal fluid, seminal cells and whole semen.