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. 2016 Mar 11;3(2):ofw057.
doi: 10.1093/ofid/ofw057. eCollection 2016 Mar.

Shedding of Hepatitis C Virus in Semen of Human Immunodeficiency Virus-Infected Men

Samuel S Turner  1 , Sara Gianella  2 , Marcus J-S Yip  1 , Wouter O van Seggelen  1 , Robert D Gillies  1 , Andrew L Foster  1 , Zachary R Barbati  1 , Davey M Smith  3 , Daniel S Fierer  1
Affiliations

Shedding of Hepatitis C Virus in Semen of Human Immunodeficiency Virus-Infected Men

Samuel S Turner et al. Open Forum Infect Dis. .

Abstract

Background. The epidemic of sexually transmitted hepatitis C virus (HCV) infection among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) has been documented for over a decade. Despite this, there is no consensus as to the risk factors for sexual acquisition of HCV in these men. Methods. We obtained paired semen and blood samples at 2-week intervals from HIV-infected MSM with recent and chronic HCV infection and quantified HCV in semen. Results. Hepatitis C virus was quantified in 59 semen specimens from 33 men. Hepatitis C virus was shed in 16 (27%) of semen specimens from 11 (33%) of the men. Median HCV viral load (VL) in semen was 1.49 log10 IU/mL. Hepatitis C virus VL in blood was significantly higher at the time of HCV shedding in semen than when HCV shedding in semen was not detected (P = .002). Furthermore, there was a significant correlation between the HCV VL in blood and semen overall (rs = 0.41; P = .001), and in the subgroup with recent HCV infection (rs = 0.37; P = .02), but not in the subgroup with chronic HCV infection (rs = 0.34; P = .1). Conclusions. One third of HIV-infected MSM coinfected with HCV shed HCV into their semen. Based on the HCV VL in semen in this study, an average ejaculate would deliver up to 6630 IU of virus into the rectum of the receptive partner. Therefore, our data strongly support that condoms should be used during anal intercourse among MSM to prevent transmission of HCV.

Keywords: HIV-infected MSM; hepatitis C virus (HCV); semen; sexual transmission; shedding.

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Figures

Figure 1.
Figure 1.
Detection of hepatitis C virus (HCV) in semen as a function of HCV viral load (VL) in blood. Triangles represent semen specimens from HIV-infected men with recent HCV infection, and closed circles represent semen specimens from HIV-infected men with chronic HCV infection.
Figure 2.
Figure 2.
Correlation between hepatitis C virus (HCV) viral load (VL) in blood and semen. The recent HCV subgroup is shown in A; the chronic HCV subgroup is shown in B; and the combined groups are shown in C. Triangles represent semen specimens from men with recent HCV infection, and closed circles represent semen specimens from men with chronic HCV infection.
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