Frequent Cocaine Use is Associated With Larger HIV Latent Reservoir Size

Area of Science:

• Immunology
• Infectious Diseases
• Virology

Background:

• Cocaine abuse is prevalent among people living with HIV (PLWH).
• Cocaine use is associated with poorer HIV health outcomes, including higher viral load and mortality.
• Understanding cocaine's impact on the HIV latent reservoir is crucial for treatment strategies.

Purpose of the Study:

• To investigate the effect of cocaine use on the CD4+ T-cell HIV latent reservoir (HLR) in virally suppressed PLWH.
• To analyze reservoir size differences based on current, prior, and never cocaine use.

Main Methods:

• Analysis of CD4+ T-cell genomic DNA from 434 women in a US national cohort.
• Quantification of intact provirus per 10^6 CD4+ T cells using the Intact Proviral HIV DNA Assay.
• Stratification of participants into current cocaine users, prior users, and never users.

Main Results:

• HIV latent reservoir size was significantly larger in prior and current cocaine users compared to never users.
• Median HLR was 72 (IQR: 14-193) for never users, 165 (IQR: 63-387) for prior users, and 184 (IQR: 28-502) for current users.
• These differences were statistically significant (P=0.023 for prior, P=0.001 for current users).

Conclusions:

• Cocaine use may increase the size of the replication-competent HIV latent reservoir in CD4+ T cells.
• Findings are significant given the underrepresentation of women in HIV reservoir research.
• Further research is needed to understand the clinical implications of cocaine use on HIV reservoir dynamics in women.