Persistence of human immunodeficiency virus in semen after adding indinavir to combination antiretroviral therapy

Kenneth H. Mayer*, Stephen Boswell, Robert Goldstein, Wilson Lo, Chong Xu, Lynne Tucker, Maria Pia DePasquale, Richard D'Aquila, Deborah J. Anderson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

80 Scopus citations


Changes in human immunodeficiency virus (HIV) type 1 concentration and protease genotype were evaluated in semen specimens from 22 HIV-positive men before and 6 months after the addition of indinavir to dual nucleoside therapy. Seminal HIV was detected by polymerase chain reaction analysis for DNA or RNA for 59% of men before combination treatment and persisted at 6 months for 31% of the men who initially had seminal HIV detected (P = .026). The maximum levels of cell-free RNA, cell-associated RNA, and proviral DNA in semen before treatment and at 6 months were 400,000 and 10,000 copies/mL, 70,000 and 27,000 copies/mL, and 80,000 and 3,000 copies/mL, respectively. Three of the four men with persistent seminal DNA had plasma viral loads of >10,000 copies/mL before treatment. One patient who became intolerant to indinavir had seminal HIV RNA detected by PCR analysis after 6 months. Although none of the cultures of semen specimens from the four men with PCR analysis-detectable seminal DNA after 6 months yielded HIV, indinavir resistance mutations were identified in a seminal leukocyte DNA specimen from one patient, and a second patient whose therapy was switched to saquinavir had different protease inhibitor resistance mutations in seminal and blood leukocyte DNA specimens. HIV-1 protease inhibitor resistance mutants may emerge in the semen of patients receiving combination therapy.

Original languageEnglish (US)
Pages (from-to)1252-1259
Number of pages8
JournalClinical Infectious Diseases
Issue number6
StatePublished - 1999

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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