Reply: Choice of ART programme for serodiscordant couples with an HIV-infected male partner

Background:: HIV transmission during pregnancy and breastfeeding among serodiscordant heterosexual couples represents an ongoing barrier to elimination of vertical transmission of HIV-1 infection in Canada. Objective:: To report a case of vertical HIV transmission during breastfeeding and examine the prevalence of risk factors for HIV transmission in the pregnancy and postpartum periods among serodiscordant couples where the male partner is HIV positive and female partner HIV negative. Methods:: Case report and retrospective chart review of HIV-serodiscordant pregnant couples over an eight-year period in Edmonton, Canada. Results:: We report a case of maternal primary HIV infection during the postpartum period and vertical transmission to a nursing infant that went undetected until the infant presented with AIDS. We also report a series of 41 serodiscordant pregnant couples identified by our public health nurse between 2008 and 2016. Among HIV-infected male partners, 20 (49%) had detectable viral load (VL) during their partner’s pregnancy and during breastfeeding, with median peak VL 4,700 copies/mL (range 49-120,000) and 5,100 copies/mL (range 40-120,000) during pregnancy and breastfeeding, respectively. None of the female partners seroconverted during pregnancy, but three seroconverted at 1.8, 2.4, and 6.9 years after delivery. No vertical transmission occurred. Conclusion:: Despite concerted attempts to minimize HIV transmission during pregnancy and breastfeeding in our wellresourced setting, residual transmission risk remains due to non-suppressed viral load within many HIV-serodiscordant pregnant couples.

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Effect of semen washing methods on diminishing the transmission of viral infections in artificial reproductive technology

Journal of Preventive Epidemiology ◽

10.34172/jpe.2021.33 ◽

2021 ◽

Vol 6 (2) ◽

pp. e33-e33

Author(s):

Fereshteh Aliakbari ◽

Neda Taghizabet ◽

Fatemeh Rezaei-Tazangi ◽

Ebrahim Kharazi Nejad

Keyword(s):

Density Gradient ◽

Viral Infections ◽

Scientific Information ◽

Male Partner ◽

Reproductive Technology ◽

Etiologic Factor ◽

Serodiscordant Couples ◽

Accessible Information ◽

Mesh Terms ◽

Artificial Reproductive Technology

Seminal infections were considered to be an etiologic factor of male infertility. Semen washing is used as an appropriate technique in artificial reproductive technology (ART) for serodiscordant couples when the partner of male is contaminated. The aim of this study was to investigate the role of semen washing methods in reducing the transmission of viral infections in ART. In this narrative review we investigated accessible information from Google Scholar, PubMed, Scopus, Web of Science, IranMedex, Irandoc, Magiran, SID, MEDLIB and Scientific Information Database until 2019. The MeSH terms of semen washing, HIV, assisted reproduction, serodiscordant, and virus transmission were used. According to the search strategy, 89 articles were discovered. After checking the titles, abstracts and manuscripts, a collection of 45 papers were chosen pursuant to the suitability indexes. The studies were performed around different categories of semen washing (swim up, density gradient) in serodiscordant couples. Some studies highlighted that semen washings can completely prevent viral transmission, but a few do not believe this claim. However, scientific researchers have revealed that sperm washing may diminish the possibility of infection in serodiscordant couples where the male partner is infected. Swim up in combination with density gradient is a suitable method to diminish the transmission of infections.

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