Determinants of human immunodeficiency virus DNA and RNA shedding in the anal-rectal canal of homosexual men

J Infect Dis. 1998 Mar;177(3):571-8. doi: 10.1086/514239.


To define the determinants of anal-rectal shedding of human immunodeficiency virus (HIV) DNA and RNA, 374 HIV-seropositive homosexual men were tested. Factors independently associated with detection of anal-rectal HIV DNA included anal-rectal inflammation and detection of anal human papillomavirus DNA; predictors of HIV RNA included detection of anal-rectal HIV DNA, anal-rectal inflammation, and high plasma HIV RNA levels. The latter (>10,000 copies/mL) was the main determinant of anal-rectal HIV RNA shedding when HIV DNA (e.g., HIV-infected cells) was not detected in the anal-rectal sample. The local presence of HIV-infected cells and local inflammation were the principal determinants of HIV RNA among those with low (<10,000 copies/mL) plasma HIV RNA load. Among those with anal-rectal HIV DNA present, increased HIV RNA plasma load did not increase the risk of shedding of HIV RNA into the anal-rectal canal.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anal Canal / pathology
  • Anal Canal / virology
  • Bisexuality
  • DNA, Viral / analysis
  • HIV Seropositivity / virology*
  • Homosexuality
  • Humans
  • Intestinal Mucosa / virology
  • Male
  • Middle Aged
  • Prospective Studies
  • RNA, Viral / analysis
  • RNA, Viral / blood
  • Rectum / pathology
  • Rectum / virology*
  • Virus Shedding*


  • DNA, Viral
  • RNA, Viral