It has been estimated that 35 million people worldwide and 0.2% of Italian population has a chronic HIV-1 infection. The use of antiretroviral drugs has provided a noteworthy improvement in both the quality and the expectancy of life of people infected with HIV; therefore, as three quarters of infected people are in their reproductive years, many couples with an HIV positive partner can consider pregnancy planning. The aims of this study were twofold: the first aim was to assess the effect of HIV-1 infection on semen parameters; the second aim was to evaluate the effects of highly active antiretroviral therapy (HAART) on sperm DNA fragmentation comparing HIV-1 infected patients receiving HAART versus naïve HIV-1 infected patients For the first aim of the study, we retrospectively analyzed semen samples obtained from 770 HIV-1 patients recruited between January 2005 and June 2015 in our Unit of Assisted Reproduction. Co-infections with HBV or HCV and genital tract infections represented exclusion criteria; all patients received HAART and had a CD4 count > 200 cells/mm3. Complete semen analysis was performed according to WHO 2010 recommendations, with each semen variable of the study population being compared with the WHO reference group. For the second aim of the study we performed a case-control prospective study. 75 men infected with HIV-1 were recruited between January 2010 and June 2015 in our Unit. 51 HIV-1 infected patients receiving HAART (Group A) were compared to 24 HIV-1 infected patients who did not receive HAART (Group B). Sperm DNA fragmentation and semen analysis was performed using chromatin dispersion test (SCD) to evaluate the effect of HAART on sperm DNA fragmentation. Median values of all assessed semen parameters were within a normal range, but significantly lower compared to WHO median values (p<0.05). In addition, for each semen variable, a significant proportion of HIV-1 infected patients had values below the 5° percentile of the WHO 2010 reference group (p 30% whereas in Group B 9 patients (37.5%) showed sperm DNA fragmentation > 30% (p<0.02) (Table 2). We did not observe any correlation between antiretroviral therapy and semen parameters. Our study provides evidence that a significant proportion of HIV-1 infected patients have impaired semen parameters values below the 5° percentile of the WHO 2010 reference group and therefore a possible altered fertility. Oxidative stress, as a response to possible HIV mitochondrial damage induced by HAART, could damage sperm DNA and alter sperm quality. In addition, the results of our study demonstrate that sperm nuclear fragmentation rate increases in HIV-1 infected patients receiving antiretroviral therapy when compared to HIV-1 infected patients who do not receive therapy. Integrity of sperm DNA is also known to influence a couple’s fertility and possible predicts the chances of pregnancy and its successful outcome. In the light of these results, reproductive counselling is strongly suggested for all couples with HIV-1 male partner who desire a pregnancy.

Effects of HIV-1 infection and retroviral therapy on semen parameters and sperm DNA integrity / V. Savasi, A. Laoreti, B. Parrilla, M. Oneta, M. Musto, I. Cetin. ((Intervento presentato al 18. convegno SIMP tenutosi a Assisi nel 2015.

Effects of HIV-1 infection and retroviral therapy on semen parameters and sperm DNA integrity

V. Savasi
;
A. Laoreti
;
I. Cetin
2015

Abstract

It has been estimated that 35 million people worldwide and 0.2% of Italian population has a chronic HIV-1 infection. The use of antiretroviral drugs has provided a noteworthy improvement in both the quality and the expectancy of life of people infected with HIV; therefore, as three quarters of infected people are in their reproductive years, many couples with an HIV positive partner can consider pregnancy planning. The aims of this study were twofold: the first aim was to assess the effect of HIV-1 infection on semen parameters; the second aim was to evaluate the effects of highly active antiretroviral therapy (HAART) on sperm DNA fragmentation comparing HIV-1 infected patients receiving HAART versus naïve HIV-1 infected patients For the first aim of the study, we retrospectively analyzed semen samples obtained from 770 HIV-1 patients recruited between January 2005 and June 2015 in our Unit of Assisted Reproduction. Co-infections with HBV or HCV and genital tract infections represented exclusion criteria; all patients received HAART and had a CD4 count > 200 cells/mm3. Complete semen analysis was performed according to WHO 2010 recommendations, with each semen variable of the study population being compared with the WHO reference group. For the second aim of the study we performed a case-control prospective study. 75 men infected with HIV-1 were recruited between January 2010 and June 2015 in our Unit. 51 HIV-1 infected patients receiving HAART (Group A) were compared to 24 HIV-1 infected patients who did not receive HAART (Group B). Sperm DNA fragmentation and semen analysis was performed using chromatin dispersion test (SCD) to evaluate the effect of HAART on sperm DNA fragmentation. Median values of all assessed semen parameters were within a normal range, but significantly lower compared to WHO median values (p<0.05). In addition, for each semen variable, a significant proportion of HIV-1 infected patients had values below the 5° percentile of the WHO 2010 reference group (p 30% whereas in Group B 9 patients (37.5%) showed sperm DNA fragmentation > 30% (p<0.02) (Table 2). We did not observe any correlation between antiretroviral therapy and semen parameters. Our study provides evidence that a significant proportion of HIV-1 infected patients have impaired semen parameters values below the 5° percentile of the WHO 2010 reference group and therefore a possible altered fertility. Oxidative stress, as a response to possible HIV mitochondrial damage induced by HAART, could damage sperm DNA and alter sperm quality. In addition, the results of our study demonstrate that sperm nuclear fragmentation rate increases in HIV-1 infected patients receiving antiretroviral therapy when compared to HIV-1 infected patients who do not receive therapy. Integrity of sperm DNA is also known to influence a couple’s fertility and possible predicts the chances of pregnancy and its successful outcome. In the light of these results, reproductive counselling is strongly suggested for all couples with HIV-1 male partner who desire a pregnancy.
dic-2015
Settore MED/40 - Ginecologia e Ostetricia
Effects of HIV-1 infection and retroviral therapy on semen parameters and sperm DNA integrity / V. Savasi, A. Laoreti, B. Parrilla, M. Oneta, M. Musto, I. Cetin. ((Intervento presentato al 18. convegno SIMP tenutosi a Assisi nel 2015.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/357581
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