Article Text

Antiretroviral drug concentrations in semen of HIV-1 infected men
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  1. Stephen Taylor1,
  2. Arlene S Pereira2
  1. 1PHLS Antiviral Susceptibility Reference Unit, Division of Immunity and Infection, University of Birmingham, and Department of Sexual Medicine, Birmingham Heartlands Hospital, UK
  2. 2Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC 27599, USA
  1. S Taylor s.taylor.1{at}bham.ac.uk

Abstract

Because semen is a major vehicle for the sexual transmission of HIV-1, control of viral replication within the sanctuary of the male genital tract should be a goal of antiretroviral therapy. Local immune responses, virus specific factors, and the degree of viral and cellular trafficking all appear to be important in controlling viral replication and evolution. However, the most important factor influencing viral replication and evolution within the male genital tract may be the disposition of antiretroviral agents into genital tissues and fluids. This review proposes possible mechanisms of antiretroviral distribution into the male genital tract by using other sanctuary barriers; such as the placenta, renal tubules, and blood-brain barrier; as models. In addition, this review summarises recent clinical studies regarding the disposition of currently available antiretroviral drugs into the seminal plasma and discusses some of the difficulties in interpreting drug concentration in the genital tract.

  • HIV
  • semen
  • antiretrovirals
  • drug concentrations
  • pharmacokinetics
  • protein binding

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Supplementary materials

  • Table 1 (on the STI website) describes the lipid solubility of select antiretrovirals. GIF ImageGIF Image

Footnotes

  • website extra A table detailing antiretroviral drugs appears on the STI website. www.sextransinf.com

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