Effects of highly active antiretroviral therapy on semen parameters of a cohort of 770 HIV-1 infected men

Abstract

Background HIV-1 infected patients show impaired semen parameters. Currently, it is not clear whether HIV-1 infection itself or antiretroviral therapy have an effect on semen parameters. We aim evaluate semen quality in a large cohort of fertile HIV-1 infected men under stable highly active antiretroviral therapy (HAART) and to assess the effect of HAART type and duration on semen parameters. Materials and methods Between January 2010 and June 2014, we enrolled in a retrospective case-control study 770 HIV-1 patients under stable HAART asking a reproductive counselling with their HIV negative partner. Co-infections with HBV or HCV, genital tract infections and known causes of infertility represented exclusion criteria. Semen samples were analysed and compared with the WHO reference values. A multivariate analysis including HAART type and duration, age, viral load and CD4 count, was performed on 600 patients out of 770. Results The median values of all semen parameters were significantly lower among HIV-1 infected patients compared to the WHO reference group, with a significant proportion of patients having values below the 5th percentile of the WHO reference value. In a multivariate analysis, only age and viral load negatively impacted progressive motility (β -0.3 (95% CI: -0.5; -0.0) %, p<0.05) and semen morphology (β -0.00 (95% CI: -0.00; -0.00) %, p≤0.01), while no associations were detected as regards HAART type and duration. Conclusions HIV-1 infected patients showed a significant impairment of semen parameters compared to the reference values. HAART type and duration showed no associations with semen quality. Further research is needed to investigate implications for clinical care of HIV infected men desiring a child.

The European Academy of Andrology (EAA) ultrasound study on healthy, fertile men: clinical, seminal and biochemical characteristics

“…The present manuscript represents an introductory report on the development and methodology of the "EAA ultrasound study" (http:// www.andro logya cademy.net/studi es) 23 The main characteristics of the semen parameters found in the cohort were consistent with those reported by the WHO 7 for both the 50th and the 5th centiles for fertile men. This is relevant, because in other studies [50][51][52] comparing their data with those of the WHO 7 the mean or median values of the semen parameters of the investigated cohort were consistent with those of the WHO, 7 but there was a higher prevalence of subjects with seminal values below the 5th centile than in the present study.…”

Thoughts on the popularity of ICSI

“…In fact, spermatozoa lack an HIV receptor and therefore the male gametes themselves are not infected as the virus is only present in seminal plasma [ 101 ]. Even though sperm processing by density gradient can yield viral-free samples safe for insemination and a seronegative offspring has been born from IUI using decontaminated spermatozoa from seropositive male [ 102 ], patients treated with HAART may present with impaired semen parameters including volume, concentration, progressive motility and compromised morphology [ 103 ]. In addition to an already impaired semen sample, proper sperm processing is required to remove excess viral particles, resulting in loss of additional sperm cells, leaving ICSI as the preferable insemination option to ensure successful treatment outcome [ 99 , 104 , 105 ].…”

Histopathological changes in Oreochromis mossambicus (Peters, 1852) ovaries after a chronic exposure to a mixture of the HIV drug nevirapine and the antibiotics sulfamethoxazole and trimethoprim

“…Still, information is lacking on the long-term effects of ARVs alone or in mixture with other pharmaceuticals in surface water on fish reproduction. Different studies on human HIV patients have argued that the ARVs treatment may have effects on the reproductive system which may be the cause of infertility cases observed in many HIV/AIDS patients ( Pavili et al., 2010 ; Kushnir and Lewis 2011 ; Savasi et al., 2019 ). Studies on the reproductive system of HIV/AIDS patients have shown abnormalities in male semen and female oocyte mitochondrial DNA as well as histopathological changes in the seminiferous tubules ( Da Silva et al., 1990 ; Azu 2012 ; Savasi et al., 2019 ).…”

“…Different studies on human HIV patients have argued that the ARVs treatment may have effects on the reproductive system which may be the cause of infertility cases observed in many HIV/AIDS patients ( Pavili et al., 2010 ; Kushnir and Lewis 2011 ; Savasi et al., 2019 ). Studies on the reproductive system of HIV/AIDS patients have shown abnormalities in male semen and female oocyte mitochondrial DNA as well as histopathological changes in the seminiferous tubules ( Da Silva et al., 1990 ; Azu 2012 ; Savasi et al., 2019 ). Studies with laboratory rats treated with ARVs have also reported histological alterations of seminiferous tubules and a decrease in sperm motility ( Adaramoye et al., 2012 ; Azu et al., 2014 ; Oyeyipo et al., 2018 ).…”