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 naýve 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 log10 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/ mm3. Men with CD4 counts <350 had higher baseline mean log10 plasma viral load than those with CD4 counts ≥350 cells/mm3 (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 log10plasma viral load was significantly associated with reduction in mean log10 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 naýve men.e. © 2014 Kigozi et al.