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Not all symptomatic men will have detectible Zika virus RNA in semen
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Findings published in The New England Journal of Medicine suggest that not all men who are symptomatically infected with the Zika virus will have detectible viral RNA in their semen, researchers said.
According to the results of a study of 12 Zika-infected men in French Guiana, the average duration of Zika virus RNA in semen was 26 days, shorter than has been previously reported.
The CDC recommends that male patients with Zika wait at least 6 months after infection before trying to conceive a child or have unprotected sex, guidance based in part on reports of Zika virus RNA being detected in semen for extended periods of time, including up to 188 days in one case.
Concerns about Zika’s persistence in semen have led to warnings about semen donations among men who live in or have traveled to areas where the virus is being transmitted by mosquitoes.
Franck de Laval, MD, of the Military Center for Epidemiology and Public Health in Marseille, France, and colleagues, who authored the NEJM report, said most published studies on Zika’s persistence in semen have been based on a single semen sample from one Zika-infected patient. By comparison, their study included results from a dozen Zika-infected men for whom semen samples were available.
De Laval and colleagues determined the prevalence of Zika virus RNA, the duration of Zika persistence and potential intermittent Zika virus excretion in each patient.
According to the results, Zika virus RNA was not detected in the semen of four men. One man excreted the virus in his semen for at least 3 days and seven excreted it for at least 1 month, de Laval and colleagues reported. The longest they found detectible Zika virus RNA in semen was 45 days, “although the interval could have been longer, since the next round of testing was typically not performed until at least 2 months after symptom onset,” they wrote.
De Laval and colleagues said they did not find a significant correlation between the highest Zika virus viral load in semen and the highest viral load in serum, “which suggests that local Zika virus replication occurs in testicles or seminal glands, as reported previously.”
“The presence of [Zika virus RNA] in semen on RT-PCR analysis does not indicate whether the virus is viable or whether there is shedding of nucleic acid,” they wrote. “More data are needed to better inform public health recommendations.” – by Gerard Gallagher
Disclosure: The researchers report no relevant financial disclosures.
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