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Viral Load in Blood and Semen (VIRAL LOAD IN SEMEN VERSUS BLOOD)

Aug 14, 2007

Have there been any studies correlating viral loads as determined by blood analysis versus viral load in semen?

Response from Dr. Frascino


Yes, generally they correlate. However, there can be cases where the levels differ. (See below.)

Dr. Bob

hiv viral load in semen versus blod Nov 30, 2006

Hi Dr. Bob,

Please settle a dicussion I've been having on an hiv information site to which I subscribech higher is the viral load in semen versus blood ? I read a study a while ago stating it could be hundreds of times higher in semen, but I can't find the article in the stack of printouts on my desk. Can you settle this question ? Thanks, btw I enjoy your strange but true columns. Bertbear

Response from Dr. Frascino

Hello Bertbear,

Recent studies show that HIV viral load in blood plasma and ejaculate are generally well correlated. True, there have been some studies that have found detectable viral loads in seminal fluids, despite undetectable plasma viral loads. These may be the studies you were referring to. These reports garnered some attention awhile ago, because they help reinforce the notion that despite an undetectable viral load an HIV-positive person is still infectious and must adhere to safer sex precautions.

Stay well, Bertbear

Dr. Bob

The Super Shedders and Other Retrovirus Tales

By Enid Vázquez

May/June 2003

News from the 10th Conference on Retroviruses and Opportunistic Infections (CROI), the most important HIV medical conference held in the U.S., held this year in Boston in February. Visit for more information.


HIV in genital secretions might increase the risk of transmission. British researchers called some men "seminal super-shedders" because of the unusually high amount of virus found in their semen (actually, their "seminal plasma").

They wrote that usually viral load in semen is found less frequently, and at lower levels, than in the blood. The study looked at the semen of men who were not on therapy and had a viral load greater than 400. The majority, 58% of the 73 men, had detectable virus in their semen, but not higher than that found in their blood. A third had a seminal viral load less than 400. (This doesn't mean the virus wasn't there -- it might need to be measured differently, such as using tissue samples.)

This left 12% (nine men) who were super-shedders. Even though their blood viral load was not statistically different from that of the other shedders (the majority group), their semen viral load was significantly higher. Their T-cell counts and AIDS status were also the same as that of the other shedders.

The technology used to measure viral load throughout the body is not available in clinics. Therefore, people may be at greater risk of transmitting HIV without knowing it.

Terrified, alone and far away from home

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