Use of a motile spermatozoa isolation process was assessed for reducing the transmission of HIV and hepatitis C virus (HCV) during artificial insemination in HIV-serodiscordant couples in which the man is infected.
Thirty-two HIV-1-infected clinically asymptomatic men, having a median CD4 cell count of 396 × 106/l and a median blood plasma HIV-1 RNA content of 414 copies/ml. Of these, 16 were infected with both HIV and HCV.
Motile spermatozoa were isolated from 51 semen samples by density gradient and ‘swim-up'. HIV-1 and HCV genomes were detected and quantified in the blood plasma and seminal plasma, and detected in seminal cell fractions obtained during spermatozoa isolation.
HIV-1 RNA was detected in 30% of seminal plasma samples. HIV-1 genomes were found in 18% of seminal cell samples, but in none of the motile spermatozoa fractions after ‘swim-up'. There was no correlation between the HIV-1 RNA concentrations in the blood and seminal plasma. HIV-1 genome was detected intermittently in patients who gave more than one sample. HCV RNA was detected in 20% of seminal plasma samples from HCV viraemic patients, but in no seminal cells or motile spermatozoa fractions.
Purification of motile spermatozoa by density gradient plus ‘swim-up’ reduced the HIV-1 and HCV genomes in the semen of infected individuals to undetectable levels. This method, associated with a standardized virus assay, could be useful for serodiscordant couples (males infected) who wish to have children.
From the Laboratoire de Virologie, Hôpital Purpan, aCECOS Midi-Pyrénées, Centre de Stérilité Masculine and Human fertility Research Group, CHU La Grave, the bObstetric Department, Hôpital Lagrave, and the cInfectious Disease Department, Hôpital Purpan, Toulouse, France.
Received: 8 May 2000;
revised: 8 June 2000; accepted: 14 June 2000.
Sponsorship: Supported by L'agence Nationale de recherche sur le SIDA (ANRS 096).