title: 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.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 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.
authors.forename: Jade
authors.initials: J
authors.lastname: Ghosn
authors.affiliation: Université Paris Descartes, EA 7327, Université Paris Descartes PRES Sorbonne Paris-Cité APHP, Laboratoire de Microbiologie, Centre Hospitalier Universitaire Necker Enfants Malades, Paris.
authors.forename: Marianne
authors.initials: M
authors.lastname: Leruez-Ville
authors.affiliation: INSERM, UMR912 (SESSTIM) Aix Marseille Université, UMR_S912, IRD ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Blanche
authors.affiliation: 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.
authors.forename: Aurore
authors.initials: A
authors.lastname: Delobelle
authors.affiliation: 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.
authors.forename: Céline
authors.initials: C
authors.lastname: Beaudoux
authors.affiliation: APHP, Laboratoire de Microbiologie, Centre Hospitalier Universitaire Necker Enfants Malades, Paris.
authors.forename: Laurence
authors.initials: L
authors.lastname: Mascard
authors.affiliation: APHP, Laboratoire de Microbiologie, Centre Hospitalier Universitaire Necker Enfants Malades, Paris.
authors.forename: Hervé
authors.initials: H
authors.lastname: Lecuyer
authors.affiliation: APHP, Service de Médecine Interne, Centre Hospitalier Universitaire de Bicêtre, Kremlin Bicêtre.
authors.forename: Ana
authors.initials: A
authors.lastname: Canestri
authors.affiliation: APHP, Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire Bichat Claude Bernard, Paris.
authors.forename: Roland
authors.initials: R
authors.lastname: Landman
authors.affiliation: Service de Médecine Interne, Hôpital Foch, Suresnes.
authors.forename: David
authors.initials: D
authors.lastname: Zucman
authors.affiliation: APHP, Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire Saint Louis.
authors.forename: Diane
authors.initials: D
authors.lastname: Ponscarme
authors.affiliation: APHP, Service de Médecine Interne A, Centre Hospitalier Universitaire Lariboisière, Paris, France.
authors.forename: Agathe
authors.initials: A
authors.lastname: Rami
authors.affiliation: 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.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Viard
authors.affiliation: INSERM, UMR912 (SESSTIM) Aix Marseille Université, UMR_S912, IRD ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille.
authors.forename: Bruno
authors.initials: B
authors.lastname: Spire
authors.affiliation: Université Paris Descartes, EA 7327, Université Paris Descartes PRES Sorbonne Paris-Cité APHP, Laboratoire de Microbiologie, Centre Hospitalier Universitaire Necker Enfants Malades, Paris.
authors.forename: Christine
authors.initials: C
authors.lastname: Rouzioux
authors.affiliation: 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.
authors.forename: Dominique
authors.initials: D
authors.lastname: Costagliola
authors.affiliation: INSERM, UMR912 (SESSTIM) Aix Marseille Université, UMR_S912, IRD ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille.
authors.forename: Marie
authors.initials: M
authors.lastname: Suzan-Monti
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D004279:DNA, Viral / Q000032:analysis*; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1 / Q000235:genetics / Q000502:physiology*; D018451:Homosexuality, Male; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000737:chemistry; D008297:Male; D008385:Marijuana Smoking; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis; D012661:Semen / Q000737:chemistry / Q000821:virology*; D015231:Sexually Transmitted Diseases, Bacterial / Q000175:diagnosis; D019562:Viral Load; D017201:Virus Shedding
chemical_list: D019380:Anti-HIV Agents; D004279:DNA, Viral; D012367:RNA, Viral
keywords: compartmentalization; seminal HIV-RNA; sexual transmission; sexually transmitted infections