ArticleJournal of acquired immune deficiency syndromes (1999)2013
Changes in plasma viral load and penile viral shedding after circumcision among HIV-positive men in Kisumu, Kenya.
Article in Journal of acquired immune deficiency syndromes (1999), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 10 citations in OpenAlex.
- Circumcision status at HIV infection is not associated with plasma viral load in men: analysis of specimens from a randomized controlled trial.BMC infectious diseases · 2018Trial
- HIV shedding from male circumcision wounds in HIV-infected men: a prospective cohort study.PLoS medicine · 2015Trial
- Association between male circumcision and incidence of syphilis in men and women: a prospective study in HIV-1 serodiscordant heterosexual African couples.The Lancet. Global health · 2014Trial
- Penile Immune Activation and Risk of HIV Shedding: A Prospective Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Article
- Safety and efficacy of the PrePex device in HIV-positive men: A single-arm study in Zimbabwe.PloS one · 2017Article
- Men's Understanding of and Experiences During the Postcircumcision Abstinence Period: Results From a Field Study of ShangRing Circumcision During Routine Clinical Services in Kenya and Zambia.Journal of acquired immune deficiency syndromes (1999) · 2016Article
- Voluntary medical male circumcision in resource-constrained settings.Nature reviews. Urology · 2015Review
- Herpes Simplex [corrected] Virus Type 2 Shedding From Male Circumcision Wounds in Rakai, Uganda.The Journal of infectious diseases · 2015Observational
- Effects of medical male circumcision (MC) on plasma HIV viral load in HIV+ HAART naïve men; Rakai, Uganda.PloS one · 2014Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundWe conducted a prospective cohort study of HIV-positive men aged 18-35 years in Kisumu, Kenya to determine if medical circumcision of ART-naive HIV-positive men leads to increased viral load and penile viral shedding.
methodsFrom 108 HIV-positive men circumcised by forceps-guided method and followed up weekly for 6 weeks, 29 men were evaluated for penile viral shedding. HIV-1 RNA was measured in plasma from 19 men and in penile lavage samples from 29 men. Samples were collected before circumcision and at weekly intervals for 6 weeks or until the circumcision wound was healed. CD4 T-cell counts from 102 HIV-positive men were determined at baseline and at 2 weeks thereafter. Wounds with healthy scar, no scab or opening, and no suture tracks were deemed healed.
resultsAmong 65 ART-naive men, mean CD4 T-cell count increased from 417 cells per cubic millimeter at baseline to 456 cells per cubic millimeter after 2 weeks (P = 0.04), but did not change in the 37 men on ART (P = 0.81). There was no change in HIV plasma viral load (P = 0.36), but penile viral shedding rose significantly within 1 week after circumcision then declined to undetectable levels by 6 weeks (multivariate analysis of variance; P < 0.001). In 28 of 29 men (96.6%), there was no detectable viral shedding after certification of wound healing.
conclusionsMedical circumcision among ART-naive HIV-infected men results in a transitory rise in penile viral shedding before complete wound healing, which should pose no additional risk of HIV transmission if men adhere to 6 weeks postcircumcision sexual abstinence and use condoms consistently.
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