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Clin Infect Dis. 2014 Jun;58(12):1763-70. doi: 10.1093/cid/ciu187. Epub 2014 Mar 18.

HIV-1 DNA levels in peripheral blood mononuclear cells and cannabis use are associated with intermittent HIV shedding in semen of men who have sex with men on successful antiretroviral regimens.

Author information

1
Université Paris Descartes, EA 7327, Université Paris Descartes PRES Sorbonne Paris-Cité APHP, Unité Fonctionnelle de Thérapeutique en Immuno-Infectiologie, Centre Hospitalier Universitaire Hôtel-Dieu.
2
Université Paris Descartes, EA 7327, Université Paris Descartes PRES Sorbonne Paris-Cité APHP, Laboratoire de Microbiologie, Centre Hospitalier Universitaire Necker Enfants Malades, Paris.
3
INSERM, UMR912 (SESSTIM) Aix Marseille Université, UMR_S912, IRD ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille.
4
INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris.
5
APHP, Laboratoire de Microbiologie, Centre Hospitalier Universitaire Necker Enfants Malades, Paris.
6
APHP, Service de Médecine Interne, Centre Hospitalier Universitaire de Bicêtre, Kremlin Bicêtre.
7
APHP, Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire Bichat Claude Bernard, Paris.
8
Service de Médecine Interne, Hôpital Foch, Suresnes.
9
APHP, Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire Saint Louis.
10
APHP, Service de Médecine Interne A, Centre Hospitalier Universitaire Lariboisière, Paris, France.

Abstract

BACKGROUND:

Few data exist on the efficacy of combined antiretroviral therapy (cART) in semen of human immunodeficiency virus type 1 (HIV-1) infected men who have sex with men (MSM) with sustained control of HIV replication in blood.

METHODS:

HIV-1 infected MSM on successful cART for >6 months were enrolled. HIV-RNA was quantified in seminal plasma (spVL) and in blood plasma (bpVL) from 2 paired samples collected 4 weeks apart. Relationship between spVL and bpVL (measured by an ultrasensitive assay, LOQ 10 copies/mL), total peripheral blood mononuclear cells (PBMC)-associated HIV-DNA, sexually transmitted infections (STIs), and self-reported socio-behavioral characteristics was assessed using GEE logistic regression.

RESULTS:

In total, 157 patients were included. Median time with bpVL <50 copies/mL was 3.3 years. spVL was detectable in 23/304 samples (prevalence 7.6%). Median spVL was 145 cp/mL (100-1475). spVL was detectable on the first, on the second, and on both samples in 5, 14, and 2 men, respectively. In sum, 33 individuals (21%) had STIs (asymptomatic in 24/33). Residual bpVL was undetectable by ultrasensitive assay in 225/300 samples (75%). After multivariable adjustments, PBMC-associated HIV-DNA (OR 2.6[1.2; 6.0], for HIV-DNA > 2.5 log10 cp/10(6) PBMC, P = .02), and cannabis use during sexual intercourse (OR 2.8[1.2; 6.7], P = .02) were the only factors associated significantly with spVL.

CONCLUSION:

We show that HIV-RNA can be detected intermittently in semen of HIV-1 infected MSM despite successful cART. The size of blood HIV-1 reservoir predicted spVL detection. Our results indicated also that the possible effect of cannabis should be taken into account when developing prevention interventions targeted toward HIV-infected MSM on successful cART.

KEYWORDS:

compartmentalization; seminal HIV-RNA; sexual transmission; sexually transmitted infections

PMID:
24647014
DOI:
10.1093/cid/ciu187
[Indexed for MEDLINE]

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