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Session 56 Poster Session Acute Infection: Resistance, Fitness, and Transmission Session Time: 4:30-6:30 pm Room 4E-F

365-M. Relationship between Seminal and Plasma Viral Loads among Persons with Primary HIV Infection J. Kahn*1, F. Hecht1, M. Warmerdam2, L. Liu1, and R. M. Grant1 1Univ. of California, San Francisco and 2Gladstone Inst. of Virology and Immunology, San Francisco, CA Background: Recently infected persons may be more infectious to sexual partners if viral load in genital secretions is high during primary viremia, as it is in blood. Semen viral load may rise with plasma viral load, or sometime thereafter. We evaluated baseline and serial samples of plasma and semen from newly infected persons. Methods: Persons with documented recent HIV infection were referred to the UCSF Options Project. Recent infection was defined as an evolving serological test (WB, EIA, detuned EIA) or seroconversion in the past 12 months. Viral load in the plasma and the semen was determined by ultrasensitive Roche Monitor and NASBA assays, respectively. Patients were then followed prospectively. Results: Viral load was detectable in the blood plasma in 35 of 36 persons (97%) and in the seminal plasma in 21 of 36 persons (58.3%). Viral loads in the 2 compartments were positively correlated (Spearman rho 0.55; p = 0.004). Among persons with detectable viral loads in plasma and seminal plasma, the viral load was, on average, 0.5-log10 copies/mL less in the semen. After initiation of HAART, the viral load declined to undetectable levels in both plasma and seminal plasma of all patients tested. 12 subjects virologically failed HAART, defined as having a plasma viral load > 1000 copies/mL, all of which had genotypic evidence of drug resistance. 4 of 5 of these subjects (80%) were found to have undetectable viral load in the semen. Conclusions: HIV viral load in the semen and blood are positively correlated in recently infected persons prior to therapy and with treatment HIV RNA decreases in both compartments. When HAART treatment fails, seminal viral RNA is often undetectable however; HIV RNA may persist in semen when viral RNA rebounds in the blood plasma to detectable levels.

©2002 9th Conference on Retroviruses and Opportunistic Infections