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Foreskin Cells May Assist HIV Transmission

NEW YORK (Reuters Health) - Over 40 studies have found
that males who are circumcised have a lower risk of
becoming infected with HIV from an infected sexual
partner than uncircumcised men. In a report in the
June 10th issue of the British Medical Journal,
researchers provide a possible answer to the question
of how circumcision may protect against HIV infection.

The authors report that certain cells found in
abundance on the inner surface of the foreskin are
most likely ``the primary point of viral entry into
the penis of an uncircumcised man.''

Dr. Robert Szabo, of Monash University, Melbourne,
Australia, and Dr. Roger V. Short, of the University
of Melbourne, note that about 70% of men who are HIV
positive have been infected through the penis. Studies
show that circumcised men are about two to eight times
less likely to contract HIV and other sexually
transmitted diseases than uncircumcised men.

Compelling evidence that circumcision directly
protects men from HIV infection comes from a study
performed in Uganda, the authors report. In that
research, scientists studied 50 circumcised men and
137 uncircumcised men. All of the men were HIV
negative but had female partners who were HIV
positive. Over the 30 months of the study, none of the
circumcised men contracted HIV, while 40 of the
uncircumcised men contracted the virus. While all the
men had free access to condoms, 89% never used them,
Szabo and Short note.

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 Scientists speculate that uncircumcised men are at
greater risk for HIV infection because of cells called
Langerhans' cells found on the inner surface of the
foreskin. During intercourse, the foreskin can be
pulled down, exposing the Langerhans' cells to vaginal
secretions, which can carry HIV. The virus may bind to
receptors on the surface of Langerhans' cells, leading
to infection.

Removal of the foreskin also removes the Langerhans'
cells, thus reducing the risk of HIV infection from
sex with an HIV-positive partner, the researchers
conclude.

``Although condoms must remain the first choice for
preventing the sexual transmission of HIV, they are
often not used consistently or correctly, they may
break during use, and there may be strong cultural and
aesthetic objections to using them,'' Szabo and Short
write.

Therefore, circumcising males could help reduce rates
of HIV transmission, the investigators suggest. But
circumcising boys at the time of birth would not
affect transmission rates for 15 to 20 years.
``Circumcision at puberty, as practised by many Muslim
communities, would be the most immediately effective
intervention for reducing HIV transmission since it
would be done before young men are likely to become
sexually active,'' the team concludes.

Szabo and Short also suggest that the development of
agents that can be applied to the penis, a ``chemical
condom'' that blocks HIV from entering cells, may also
help to reduce transmission rates, and ``might be more
effective and acceptable than any mechanical barrier
or surgical intervention.''

SOURCE: British Medical Journal 2000;320:1592-1594. 


=====
Wassalam.

IMMI

                 ====&&&&    Dan adalah orang Islam itu :    &&&=======

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