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Retroviruses and retrotransposons both insert copies of their genetic elements into the genome of the host cell. Thus, the viral genes are passed on when the host genome is replicated or translated. A typical retroviral DNA sequence contains 3-4 genes that encode the different proteins required for its structural assembly and function as a molecular parasite. This DNA is transcribed into a single mRNA, which is very similar in structure to conventional mRNAs, i.e., it is capped at the 5’...
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Retroviruses and reproduction revisited.

Ann A Kiessling1

  • 1Bedford Research Foundation, 124 South Road, Bedford, MA, 01730, USA. kiessling@bedfordresearch.org.

Journal of Assisted Reproduction and Genetics
|July 15, 2018
PubMed
Summary

New HIV infections remain high in the USA, primarily through semen transmission. Condom use is still recommended, as recent guidance on undetectable viral loads may overstate safety for preventing HIV transmission.

Keywords:
Acquired immunodeficiency diseaseAssisted reproductionCondomsCytomegalovirusGeneticsHuman immunodeficiency virusSemenSexually transmitted diseaseSurrogacy

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Area of Science:

  • Virology
  • Public Health
  • Epidemiology

Background:

  • Despite effective anti-HIV medications reducing AIDS deaths, new HIV infections in the USA remain high, around 36,000 annually.
  • Semen is the primary driver of new HIV infections (88%), with needle sharing and female-to-male transmission accounting for the rest.
  • HIV is not eliminated from semen by anti-HIV therapy, necessitating continued prevention strategies.

Purpose of the Study:

  • To evaluate the safety of condomless sex for preventing HIV transmission when the infected partner has an undetectable viral load.
  • To critically assess recent CDC guidance suggesting condomless sex may be safe under specific viral suppression conditions.
  • To highlight the risks associated with abandoning condom use for HIV prevention and safe conception.

Main Methods:

  • Review and analysis of studies cited in a recent CDC MMWR regarding HIV transmission and viral suppression.
  • Examination of data on semen transmission of HIV and the efficacy of current prevention methods.
  • Assessment of the public health implications of revised recommendations on HIV prevention strategies.

Main Results:

  • Recent studies reported no HIV transmission in cases of condomless sex when the HIV-infected partner was virally suppressed on ART.
  • The CDC's interpretation and dissemination of these findings in the MMWR may not fully represent the study data.
  • Abandoning condom use based on this interpretation poses risks for HIV and other STD transmission.

Conclusions:

  • Current understanding of semen transmission of HIV is insufficient to fully support the safety of condomless sex, even with viral suppression.
  • The CDC's recent suggestion regarding condomless sex requires careful consideration due to incomplete data representation.
  • Continued emphasis on condom use remains crucial for preventing HIV and other sexually transmitted diseases, especially for women seeking conception.