Multicenter quality control of the detection of HIV-1 genome in semen before medically assisted procreation

Brigham and Women's Hospital, Boston, Massachusetts, United States
Journal of Medical Virology (Impact Factor: 2.35). 07/2006; 78(7):877-82. DOI: 10.1002/jmv.20636
Source: PubMed


Couples in whom the man is HIV-1-positive may use medically assisted procreation in order to conceive a child without contaminating the female partner. But, before medically assisted procreation, the semen has to be processed to exclude HIV and tested for HIV nucleic acid before and after processing. The performance was evaluated of the technical protocols used to detect and quantify HIV-1 in 11 centers providing medically assisted procreation for couples with HIV-1 infected men by testing panels of seminal plasma and cells containing HIV-1 RNA and/or DNA. The performance of these tests varied due to the different assays used. False positive results were obtained in 14-19% of cases. The sensitivity for RNA detection in seminal plasma was 500-1,000 RNA copies/ml, over 500 RNA copies/10(6) cells in semen cells, and for DNA detection in semen cells 50-500 DNA copies/10(6) cells. The use of silica-based extraction seemed to increase the assay performance, whereas the use of internal controls to detect PCR inhibitor did not. This first quality control highlights the need for technical improvements of the assays to detect and quantify HIV in semen fractions and for regular evaluation of their performance.

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    • "Challenges that could be encountered when assisting HIV-1 sero-discordant couples with semen decontamination procedures include the following: (i) researchers agree that the complete removal of HIV-1 from semen cannot be guaranteed (Savasi et al., 2013). Furthermore, the PCR method used for viral validation's LLD ranges between 20 and 200 viral copies/ml, whereby false negative results are possible (Pasquier et al., 2006b). Patients should be counselled that semen decontamination is merely a risk reduction method and that risk cannot be totally eliminated (Gilling-Smith et al., 2005). "
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    ABSTRACT: The risk of human immunodeficiency virus (HIV) transmission to the female partner, or potential offspring of an HIV-1 infected man can be reduced using semen decontamination procedures before assisted reproductive treatment (ART). The objective of this study was to determine the efficiency of decontaminating semen samples (n = 186) from 95 HIV-1 sero-positive patients. Aliquots of neat semen were submitted for viral validation by qualitative and quantitative polymerase chain reaction. Semen samples were processed by density gradient centrifugation in combination with a ProInsert™ tube after which aliquots of the processed sperm samples were analysed for the presence of HIV-1. Fifty-four percent of all tested neat semen samples tested positive for HIV-1 DNA, RNA or both (13.4%, 11.3% and 29.0%, respectively). From a total of 103 processed sperm samples that were submitted for viral validation, two samples tested positive for HIV-1 DNA and none for RNA. In conclusion, semen processing with the ProInsert™ followed by viral validation of processed sperm samples should be carried out when providing ART to couples where the male partner is HIV-1 sero-positive. Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
    Full-text · Article · Dec 2014 · Reproductive biomedicine online
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    • "The performance of a total of 16 protocols was compared using two panels of prepared semen samples containing HIV-1. The techniques used have improved since the 2004 CREAThE quality control [Pasquier et al., 2006a] "
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    ABSTRACT: Detection of HIV-1 RNA in semen is used commonly to determine the safety of semen processing procedures before assisted reproductive technology (ART). Using two panels of prepared semen samples containing HIV-1 the performances of protocols from 14 centers have been compared. No false-positive results were detected but false-negative results were frequent when the concentration was below 500 HIV-1 RNA copies/ml of seminal plasma. Frequency of HIV-1 RNA detection was higher on seminal cells than on seminal plasma. Assays (or protocols) for quantifying HIV-1 RNA in semen performed less well than standardized blood plasma assays. The HIV load in seminal plasma could be a useful marker of the risk of sexual transmission of the virus. Its use as a marker of global HAART efficiency in the HIV reservoir needs further study. Standardized assays are required for detection and measurement of HIV-1 RNA in semen samples.
    Full-text · Article · Feb 2012 · Journal of Medical Virology
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    • "It would therefore be advisable to adopt a HIV/ART policy for African Units that no ART can be performed if the viral load in semen is 10 000 RNA copies/ml (Pasquier et al., 2006) and >1x10 6 white blood cells/ml present in semen (World Health Organization, 1999). However, financial constraints and logistics will probably preclude viralvalidations of most seminal and possibly purified sperm samples in most African ART laboratories. "
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    ABSTRACT: The aim of this paper is to provide information, opinions and suggestions on affordable laboratory-orientated fertility screening and treatment. Resource management to provide such services in developing countries, basic and advanced assisted reproductive services and assisted reproduction treatment (ART) of patients with sexually transmitted infections are addressed. Alternative viewpoints and parallel thinking should be encouraged to synthesize and adapt first-world ART guidelines and recommendations into safe and workable directives for developing regions. Affordable African ART programmes, devoid of commercialism, can provide essential sexual health screening services en route to safe fertility services for human immunodeficiency virus type-1 (HIV-1) serodiscordant couples (male HIV-positive), who wish to have their own biological child.
    Full-text · Article · Jun 2008 · Human Reproduction
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