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Prevalence of HIV-1 Seminal Shedding in HIV-1 Infected Men who Have Sex with Men (MSM) and Association with the Size of Intracellular HIV-1 Reservoir (ANRS EP49): "We show that HIV RNA can be detected in semen of HIV-1 infected MSM despite sustained successful cART, with a significantly higher prevalence than in heterosexual men (7.6 vs 3.1% p=0.016)"
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Reported by Jules Levin
52nd ICAAC Sept 9-12 2012 SF
J GHOSN1, A Delobelle2, M Leruez-Ville3, C Beaudoux2, L Mascard3, A Canestri1, R Landman4, D Zucman5, D Ponscarme6, A Rami7, JP Viard8, B Spire9, H Lecuyer3, D Costagliola2, C Rouzioux3, M Suzan-Monti9.
1/ Bicetre Hosp Paris ; 2/ INSERM UPMC UMR S943, Paris ; 3/ Necker Hosp, Paris ; 4/ Bichat Hosp Paris ; 5/ Foch Hosp, Suresnes ; 6/ St Louis Hosp, Paris ; 7/ Lariboisiere Hosp, Paris ; 8/ Hotel Dieu Hosp, Paris ; 9/ INSERM UMR S912, Marseille, France.
Program Abstract
Background: Few data exist on the efficacy of combined antiretroviral therapy (cART) in semen of HIV-1 infected MSM.
Methods: HIV-1 infected MSM on stable successful cART with no sign of sexually transmitted infection (STI) were enrolled. Seminal plasma HIV RNA (spVL) and blood plasma HIV RNA (bpVL) were quantified from 2 paired samples collected 1 month apart. Relationship between spVL and intracellular total HIV DNA in PBMC, TPHA/VDRL, sperm culture, was assessed using a GEE logistic regression accounting for repeated sampling in the same individual.
Results: 157 patients (pts) were included. All had bpVL<50 cp/ml for at least 6 months. spVL was detectable in 23/304 samples (prevalence 7.6%) with a median of 145 cp/ml (50-1475). spVL was detectable on sample 1 in 5 pts, on sample 2 in 14 pts and on both samples in 2 pts. 32 pts (20.5%) had asymptomatic STIs: syphilis (6), G. vaginalis (4), U. urealyticum (18), N. gonorrhoeae (2), mycoplasma (1), C. trachomatis (3). There was no association between spVL and STI, CDC stage, nadir or current CD4, duration of bpVL undetectability. Intracellular PBMC HIV DNA predicted significantly spVL detection (OR (IC95%) 3.1 (1.2-7.7) for HIV DNA>2.5 log10 cp/106PBMC).
Conclusion: This is the first longitudinal study focusing on HIV MSM with supressed bpVL and no symptom of STI. We show that HIV RNA can be detected in semen of HIV-1 infected MSM despite successful cART, with a higher prevalence than previously published in heterosexual men. The size of blood HIV-1 reservoir predicts spVL detection.
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