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

• Published in: Clinical infectious diseases 2014-06, Vol.58 (12), p.1763-1770
• Main Authors: Ghosn, Jade, Leruez-Ville, Marianne, Blanche, Jérôme, Delobelle, Aurore, Beaudoux, Céline, Mascard, Laurence, Lecuyer, Hervé, Canestri, Ana, Landman, Roland, Zucman, David, Ponscarme, Diane, Rami, Agathe, Viard, Jean-Paul, Spire, Bruno, Rouzioux, Christine, Costagliola, Dominique, Suzan-Monti, Marie
• Format: Article
• Language: English
• Subjects: Adult; AIDS; Anti-HIV Agents - therapeutic use; Antiretroviral drugs; Biological and medical sciences; Blood plasma; Cannabis; Carts; Deoxyribonucleic acid; DNA; DNA, Viral - analysis; Drug Therapy, Combination; Gays & lesbians; HIV; HIV 1; HIV infections; HIV Infections - drug therapy; HIV-1 - genetics; HIV-1 - physiology; HIV/AIDS; Homosexuality, Male; Human immunodeficiency virus; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; Leukocytes, Mononuclear - chemistry; Male; Marijuana Smoking; Medical sciences; Middle Aged; Plasma; Ribonucleic acid; RNA; RNA, Viral - analysis; Semen - chemistry; Semen - virology; Seminal plasma; Sexual transmission; Sexually Transmitted Diseases, Bacterial - diagnosis; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral Load; Virus Shedding
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1093/cid/ciu187

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 2.5 log10 cp/106 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.