From ancient to emerging infections: the odyssey of viruses in the male genital tract

The male genital tract (MGT) is the target of a number of viral infections that can have deleterious consequences at the individual, offspring and population levels. These consequences include infertility, cancers of male organs, transmission to the embryo/fetal development abnormalities and sexual dissemination of major viral pathogens such as human immunodeficiency virus (HIV) and hepatitis B virus (HBV). Lately, two emerging viruses, Zika and Ebola, have additionally revealed that the human MGT can constitute a reservoir for viruses cleared from peripheral circulation by the immune system, leading to their sexual transmission by cured men. This represents a concern for future epidemics and further underlines the need for a better understanding of the interplay between viruses and the MGT. We review here how viruses, from ancient viruses that integrated the germ line during evolution through old viruses (e.g. papillomaviruses originating from Neanderthals) and more modern sexually-transmitted infections (e.g. simian zoonotic HIV) to emerging viruses (e.g. Ebola and Zika) take advantage of genital tract colonization for horizontal dissemination, viral persistence, vertical transmission and endogenization. The MGT immune responses to viruses and the impact of these infections are discussed. We summarize the latest data regarding the sources of viruses in semen and the complex role of this body fluid in sexual transmission. Finally, we introduce key animal findings that are relevant for our understanding of viral infection and persistence in the human MGT and suggest future research directions.
https://journals.physiology.org/doi/pdf/10.1152/physrev.00021.2019