Open AccessEffects of Medical Male Circumcision (MC) on Plasma HIV Viral Load in HIV+ HAART Naïve Men; Rakai, Uganda
Author(s) -
Godfrey Kigozi,
Richard Musoke,
Nehemiah Kighoma,
Stephen Watya,
David Serwadda,
Fred Nalugoda,
Noah Kiwanuka,
Fred Wâbwire-Mângen,
Aaron A.R. Tobian,
Fredrick Makumbi,
Ronald M. Galiwango,
Nelson Sewankambo,
James Nkale,
Grace Kigozi Nalwoga,
Margaret Anyokorit,
Tom Lutalo,
Ronald H. Gray,
Maria J. Wawer
Publication year - 2014
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0110382
Subject(s) - viral load , medicine , human immunodeficiency virus (hiv) , generalized estimating equation , gee , lentivirus , immunology , multivariate analysis , confidence interval , viral disease , virology , statistics , mathematics
Background Medical male circumcision (MC) of HIV-infected men may increase plasma HIV viral load and place female partners at risk of infection. We assessed the effect of MC on plasma HIV viral load in HIV-infected men in Rakai, Uganda. Methods 195 consenting HIV-positive, HAART naïve men aged 12 and above provided blood for plasma HIV viral load testing before surgery and weekly for six weeks and at 2 and 3 months post surgery. Data were also collected on baseline social demographic characteristics and CD4 counts. Change in log 10 plasma viral load between baseline and follow-up visits was estimated using paired t tests and multivariate generalized estimating equation (GEE). Results Of the 195 men, 129 had a CD4 count ≧350 and 66 had CD4 <350 cells/mm 3 . Men with CD4 counts <350 had higher baseline mean log 10 plasma viral load than those with CD4 counts ≧350 cells/mm 3 (4.715 vs 4.217 cps/mL, respectively, p = 0.0005). Compared to baseline, there was no statistically significant increase in post-MC HIV plasma viral loads irrespective of CD4. Multivariate analysis showed that higher baseline log 10 plasma viral load was significantly associated with reduction in mean log 10 plasma viral load following MC (coef. = −0.134, p<0.001). Conclusion We observed no increase in plasma HIV viral load following MC in HIV-infected, HAART naïve men.