HIV and urethritis: time required for antiretroviral therapy to suppress HIV in semen.

Autor:	Matoga M; University of North Carolina Project Malawi, Lilongwe, Malawi., Chen JS; Institute for Global Health and Infectious Diseases., Massa C; University of North Carolina Project Malawi, Lilongwe, Malawi., Thengolose I; University of North Carolina Project Malawi, Lilongwe, Malawi., Tegha G; University of North Carolina Project Malawi, Lilongwe, Malawi., Ndalama B; University of North Carolina Project Malawi, Lilongwe, Malawi., Bonongwe N; University of North Carolina Project Malawi, Lilongwe, Malawi., Mathiya E; University of North Carolina Project Malawi, Lilongwe, Malawi., Jere E; University of North Carolina Project Malawi, Lilongwe, Malawi., Banda G; University of North Carolina Project Malawi, Lilongwe, Malawi., Khan S; University of North Carolina Project Malawi, Lilongwe, Malawi., Loftis AJ; Institute for Global Health and Infectious Diseases., Kashuba A; Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC., Cottrell ML; Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC., Schauer AP; Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC., Van Horne B; Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC., Tompkins LA; Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC., Lancaster KE; The Ohio State University College of Public Health, Columbus, OH, USA., Miller WC; The Ohio State University College of Public Health, Columbus, OH, USA., Eron JJ; Institute for Global Health and Infectious Diseases., Hoffman IF; Institute for Global Health and Infectious Diseases., Cohen MS; Institute for Global Health and Infectious Diseases.
Jazyk:	angličtina
Zdroj:	AIDS (London, England) [AIDS] 2023 Nov 15; Vol. 37 (14), pp. 2233-2238. Date of Electronic Publication: 2023 Aug 02.
DOI:	10.1097/QAD.0000000000003679
Abstrakt:	Objectives: To examine the time required to suppress HIV in the genital tract with antiretroviral therapy (ART) in men with urethritis. Design: An observational cohort study. Methods: Men with HIV and urethritis not on ART were enrolled at an STI clinic in Malawi and offered to initiate ART. Blood and semen samples were collected pretreatment and at 1, 2, 4, 8, 12 and 24 weeks posturethritis treatment. Median viral loads (VLs) were calculated by ART initiation groups: 'within 1 week', 'between 1 and 4 weeks' and 'no ART before 4 weeks', based on the men's choice about whether or not to initiate ART. The presence of ART at each visit was confirmed by bioanalytical methods. Findings: Between January 2017 and November 2018, 74 men presented with urethritis and HIV and were confirmed ART naive. The median age was 32 years. Forty-one (55% of men) initiated ART within 1 week; 12 (16%) between 1 and 4 weeks; and 21 (28%) did not initiate ART by week 4. Within the 1 week group, median VL was suppressed within 4 weeks in both semen and blood. Among the 1-4 weeks group, VL was suppressed within 4 weeks in semen and 5 weeks in blood. Among the no ART before 4 weeks group, VL in semen declined within the first 4 weeks but remained unsuppressed through week 24, and there was no significant decline in blood HIV. Conclusion: Treatment of urethritis and prompt initiation of ART with counseling for safer sex for at least one month is a critical measure to reduce transmission of HIV. (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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