Poor penetration of the male genital tract by HIV-1 protease inhibitors

• Published in: AIDS (London) Vol. 13; no. 7; pp. 859 - 860
• Main Authors: TAYLOR, S, BACK, D. J, WORKMAN, J, DRAKE, S. M, WHITE, D. J, CHOUDHURY, B, CANE, P. A, BEARDS, G. M, HALIFAX, K, PILLAY, D
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 07-05-1999
• Subjects: AIDS/HIV; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Biological and medical sciences; Drug Therapy, Combination; HIV Infections - drug therapy; HIV Protease Inhibitors - pharmacokinetics; HIV Protease Inhibitors - therapeutic use; Human immunodeficiency virus 1; Humans; Male; Medical sciences; Pharmacology. Drug treatments; Reverse Transcriptase Inhibitors - therapeutic use; Ritonavir - pharmacokinetics; Ritonavir - therapeutic use; Saquinavir - pharmacokinetics; Saquinavir - therapeutic use; Semen - metabolism; Stavudine - therapeutic use; Human; Immunopathology; HIV-1 virus; Ritonavir; Semen; Retroviridae; AIDS; Concentration; Immune deficiency; Lentivirus; Male genital system; Blood plasma; Infection; Virus; Saquinavir; Chemotherapy; Treatment; Viral disease; Antiviral; Human immunodeficiency virus; Pharmacokinetics
• ISSN: 0269-9370; 1473-5571
• DOI: 10.1097/00002030-199905070-00017

In conclusion, the poor penetration of antivirals may contribute to a 'compartmental' effect, whereby HIV replication and evolution in the genital tract is subjected to different selective pressures than elsewhere in the body. The observations that drug-resistant mutants are differently represented in the two compartments support this concept. The possibility that viral load and viral species in plasma may not reflect those in the semen should only serve to reinforce the message of safer sexual practices, in order that the transmission of HIV, including drug-resistant variants, is avoided.