Viral load dynamics in plasma and semen

[Jim Allen]

A small study confirms ART suppresses VL in semen as VL drops in plasma. Broadly speaking this was already known and studied before, but I thought it was interesting but not unexpected to see how much VL spikes in semen during primary infection without ART.


Viral load dynamics in plasma and semen when ART is initiated during early HIV-1 infection.

Barbara Jungwirth, Thebodypro, Full article: https://www.thebodypro.com/article/twihr-2024-hiv-treatment-viral-load-reduction-semen

Researchers assessed HIV viral loads in semen and plasma during primary HIV infection--29 men who started antiretroviral treatment immediately and 37 men who delayed treatment between 2013 and 2017.

At baseline, semen viral load was >1,000 copies/mL in 83% of all participants, indicating potential onward transmission of the virus. In 35% of untreated participants, that level remained through the end of their study participation. In treated participants, semen viral load declined rapidly, with 25 participants achieving < 1,000 copies/mL by week 12.

By week 24 (Just under six months) 27 participants had reduced semen viral load to ≤160 copies/mL–defined as viral suppression

Study limitations reported by the authors included the small sample size and self-reported behavioral data.

The researchers said their findings suggest there is a high semen viral load during the early weeks of a primary HIV infection and that plasma viral load, the more commonly available measure, is a good but conservative predictor of semen viral load during this same time period. In addition, they reported that almost all participants treated with antiretroviral therapy maintained suppressed semen viral loads after a diagnosis of another sexually transmitted infection while many in the deferred treatment group did not.

Viral Load Dynamics in Plasma and Semen When Antiretroviral Therapy Is Initiated During Early HIV-1 Infection, The Journal of Infectious Diseases, 2023;, jiad520, https://doi.org/10.1093/infdis/jiad520

Spanish forum thread:

la carga viral de VIH en semen
https://forums.poz.com/index.php?topic=77691