학술논문
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.
Document Type
Article
Author
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
Source
Subject
*GAY men's sexual behavior
*HIV-positive men
*SEXUALLY transmitted diseases
*SEMINAL proteins
*BLOOD plasma
*ANTIRETROVIRAL agents
*
*
*
*
*
Language
ISSN
1058-4838
Abstract
We show that HIV-1 RNA shedding in semen is intermittent in controlled MSM with a higher prevalence than that reported in heterosexual HIV-1 infected men seeking for assisted reproduction techniques. Shedding was associated with the level of cellular HIV-1 reservoir and cannabis use.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/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. [ABSTRACT FROM AUTHOR]