Report from the Durban WORLD AIDS CONFERENCE
Durban, South Africa
Sunday July 9
reported by Jules Levin

Report 6

Sperm Washing: HIV, HCV

Sperm washing and virus nucleic acid detection to reduce HIV and HCV transmission in serodiscordant couples wishing to have children

C. Pasquier^{1}, L. Bujan^{2}, L. Righi^{3}, L. Berges^{3}, J. Puel^{3}, J. Izopet^{3} ^{1}Hopital Purpan, Laboratoire de Virologie, Hopital Purpan, 31059 Toulouse, France, ^{2}Hopital La Grave, Toulouse, France, ^{3}Hopital Purpan, Toulouse, France

Objectives: (1) to evaluate the prevalence of HIV-1 and HCV genomes in semen. (2) to determine the correlation between seminal and plasma viral load, CD4 cell count and treatment. (3) to assess the efficacy of sperm washing for reducing HIV and HCV transmission by insemination in serodiscordant couples wishing to have children.

Methods: A total of 51 blood/semen samples were taken from 32 HIV-1 infected individuals, included 17 subjects that had HCV viremia. Seminal plasma and various fractions of cells were separated from semen using a gradient. Motile spermatozoa were then isolated by the swim-up method. HIV-1 RNA and proviral DNA, and HCV RNA were detected using modified Roche Amplicor TM and Monitor TM assays.

Results: Paired samples were tested and HIV-1 RNA was detected in 31 % of seminal plasma samples compared to 82 % of blood plasma samples. The HIV RNA concentration in seminal plasma 'median 1.95 Log' was lower than in blood plasma '2.66 Log'. No significant correlations were found between seminal HIV-1 RNA and blood plasma HIV-1 RNA, CD4 cell count or treatment. HIV RNA varied over time in consecutive semen samples from the same individual. HCV RNA was detected in 4/20 (20 %) of the seminal plasma samples tested.

HIV-1 genome (DNA or RNA) was detected in 24 % of semen cell pellets, 23 % in the 50% cell fraction (non spermatozoa cells), but no HIV-1 genomes were found in the motile spermatozoa fraction. No HCV RNA was found in any of cell fractions of semen.

Conclusions: HCV genome can be detected in the seminal plasma of some HIV-HCV infected individuals. The absence of detectable HIV-1 and HCV genome after sperm washing + swim-up method, followed by artificial insemination, could be a safer procedure to reduce the risk of virus transmission for HIV-1 and/or HCV-discordant couples wishing to have children.

Presenting author: C. Pasquier, Hopital Purpan, Laboratoire de Virologie, Hopital Purpan, 31059 Toulouse, France, Tel.: +33 5 61 77 22 65, Fax: +33 5 61 77 25 42, E-mail: cpasquie@cict.fr