Study reveals evidence of 22 different viruses in human semen after infection

Comprehensive review reveals persistence of 22 viruses in human semen after infection, with implications for disease transmission, fertility, and future research priorities I did.

study: Duration of virus persistence in human semen after acute viral infection: a systematic review. Image credit: New Africa/Shutterstock.com

In a recent study published in lancet microorganismsa group of researchers systematically investigated virus persistence and health effects in human semen after acute infection. They also identified research gaps to inform future research.

background

Virus persistence in human semen after acute infection plays an important role in ongoing infection during an outbreak and can lead to disease relapse after the outbreak is declared over.

Due to immune privilege, the male reproductive tract acts as a reservoir for the virus, promoting its persistence. Virus shedding Despite systemic clearance.

Viral factors, immune evasion, and host characteristics such as viremia and immune competence influence persistence.

While previous research has focused on chronic infections, the emerging outbreak of acute infections highlights the need for updated insights. Further research is essential to refine clinical guidelines and inform public health strategies during outbreaks.

About research

This systematic review complied with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with the International Prospective Register of Systematic Reviews (PROSPERO).

The search was conducted across five databases covering areas relevant to the research question: Public/Publisher MEDLINE (PubMed), Excerpta Medica Database (Embase), Web of Science, Scopus, and the Program for Emerging Disease Surveillance (ProMED). Ta.

ProMED was specifically incorporated to collect gray literature, clinical reports, and preprints related to emerging outbreaks. A pilot study in July 2022 refined the search strategy to optimize sensitivity and specificity.

Studies reporting primary or secondary data on virus detection in semen during or after acute infection and evidence of sexual transmission were included. Acute infections are defined as infections that do not normally cause lifelong infection in immunocompetent individuals.

Eligible study designs include case reports, but exclude reviews, opinion articles, and commentaries. There were no restrictions on publication date, language, or population.

A two-stage search strategy was adopted for this review. The first phase identified viruses detected in semen after acute infection, and the second phase investigated evidence of sexual transmission. Titles, abstracts, and full text were systematically reviewed using Rayyan software, and discrepancies were resolved by consensus. Deduplication and reference screening ensure comprehensive inclusion.

Data extraction utilized a standardized spreadsheet to capture publication details, virus characteristics, study design, participant data, and detection methods. Results include the identity, duration, and ability of the virus detected in the semen to replicate.

Secondary outcomes focused on evidence of sexual transmission and associations with immune status. Data analysis was performed in Microsoft Excel and sufficient data were used to calculate the maximum detection period and median duration of the virus.

Research results

This systematic review included data from 24,258 studies screened at stage 1, of which 643 were retained for full-text review. This initial review identified 27 viruses associated with acute infections in humans with evidence of presence in semen or the male reproductive tract.

In stage 2, an additional 5,481 studies were identified, and 325 were retained for full-text review. A further 61 articles were added through reference screening of review articles. Ultimately, 373 studies met the eligibility criteria and were included in the analysis.

The majority of included studies were case reports (98 of 373) and case series (120 of 373). While previous reviews focused on a limited number of viruses, this systematic review spanned studies published from 1962 to 2023, providing broader coverage.

We identified evidence of 22 viruses (from 14 families) detected in semen during or after acute infection. In addition, three viruses were detected in other parts of the male genital tract but not in semen, and two viruses were not detected in semen with evidence of sexual transmission.

The analysis consisted of 208 studies with 8,387 participants. Detection methods vary, including polymerase chain reaction (PCR); antigen Detection, whole-genome sequencing, and replication in cell or animal models. Virus persistence in semen showed significant variation among pathogens.

For example, detection rates vary widely in studies that systematically test participants. ebola virus disease33-100% for Zika virus and 0-16% for coronavirus infection

Replication-competent viruses detected in semen include adenovirus, dengue virus, Ebola virus, and Zika virus. There was also evidence of sexual transmission for nine viruses, and molecular and epidemiological support for pathogens such as Zika virus, Ebola virus, and dengue virus.

The longest duration recorded was for the Ebola virus, which was detected up to 988 days after discharge from treatment. However, the median duration of most viruses was quite short. For the Zika virus, the longest duration was 941 days, but the median was only 57 days.

Variability in individual duration and uncertainty in the timing of clearance was evident, as follow-up was often terminated prematurely or gaps existed between tests. Data on immune status were limited and did not permit precise conclusions about the role of immunity in persistence.

conclusion

In summary, this systematic review identified 22 viruses that cause acute infections that can persist in human semen, significantly expanding knowledge from previous reviews. Of these, nine of the viruses had evidence of sexual transmission.

The duration of the viruses varied widely, with maximum detection times ranging from 8 days for Kyasanur forest disease virus to 988 days for Ebola virus. Detection methods include PCR, antigen assays, and replication in cells or animal models.

Immune privilege in the male genital tract may contribute to prolonged viral shedding. This persistence has important public health implications, including transmission dynamics, recurrence of epidemics, male fertility, and treatment development.