Effects of Medical Male Circumcision (MC) on Plasma HIV Viral Load in HIV+ HAART Naïve Men; Rakai, Uganda

Abstract

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.