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Published in: Archives of Gynecology and Obstetrics 1/2011

01-07-2011 | Reproductive Medicine

HIV-infection and modern antiretroviral therapy impair sperm quality

Authors: Sven Kehl, Michael Weigel, Daniel Müller, Monika Gentili, Amadeus Hornemann, Marc Sütterlin

Published in: Archives of Gynecology and Obstetrics | Issue 1/2011

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Abstract

Purpose

Serodiscordant couples with a human immunodeficiency virus type 1 (HIV-1)-infected man request assisted reproductive technology (ART) in order to achieve safe conception. Most of these men are on highly active antiretroviral therapy (HAART). HIV-1 infection and the antiretroviral drugs are blamed for semen alterations. The aim of our study was to investigate the semen parameters in HIV-1-infected patients with and without HAART and to compare their sperm characteristics with those of healthy men.

Materials and methods

A prospective study of 226 men attended the university fertility center of Mannheim between May 1996 and July 2003. The patients were divided into three groups: HIV-infected men taking antiretroviral therapy, HIV-infected patients who did not take antiretroviral therapy until now and a control group with 93 men consulting our fertility center together with their wives because of tubal sterility. Semen samples were examined with regard to ejaculate volume, sperm concentration, motility, and morphology.

Results

The study showed significant differences between the ejaculate of HIV-infected and non-infected men. The HIV-infected men as a whole group and the subgroup of men with HAART had a lower ejaculate volume, less slow progressive and more abnormally shaped spermatozoa compared with the control group. The HIV-infected men without an antiretroviral therapy had a significant lower ejaculate volume compared with the control group; the other parameters were not altered significantly. Differences between the subgroups with and without HAART were not significant.

Conclusion

The spermiogram in HIV-1-infected men in comparison to a control group of healthy men is negatively altered. Especially in men with HAART, ejaculate volume as well as sperm morphology and motility changed significantly.
Literature
4.
go back to reference Chu MC, Pena JE, Nakhuda GS, Thornton MH 2nd, Sauer MV (2006) Assessing the reproductive performance of men co-infected with HIV-1 and hepatitis C undergoing assisted reproduction. Arch Gynecol Obstet 274(3):155–159. doi:10.1007/s00404-006-0164-9 PubMedCrossRef Chu MC, Pena JE, Nakhuda GS, Thornton MH 2nd, Sauer MV (2006) Assessing the reproductive performance of men co-infected with HIV-1 and hepatitis C undergoing assisted reproduction. Arch Gynecol Obstet 274(3):155–159. doi:10.​1007/​s00404-006-0164-9 PubMedCrossRef
5.
go back to reference Gupta P, Mellors J, Kingsley L, Riddler S, Singh MK, Schreiber S, Cronin M, Rinaldo CR (1997) High viral load in semen of human immunodeficiency virus type 1-infected men at all stages of disease and its reduction by therapy with protease and nonnucleoside reverse transcriptase inhibitors. J Virol 71(8):6271–6275PubMed Gupta P, Mellors J, Kingsley L, Riddler S, Singh MK, Schreiber S, Cronin M, Rinaldo CR (1997) High viral load in semen of human immunodeficiency virus type 1-infected men at all stages of disease and its reduction by therapy with protease and nonnucleoside reverse transcriptase inhibitors. J Virol 71(8):6271–6275PubMed
6.
go back to reference Dulioust E, Tachet A, De Almeida M, Finkielsztejn L, Rivalland S, Salmon D, Sicard D, Rouzioux C, Jouannet P (1998) Detection of HIV-1 in seminal plasma and seminal cells of HIV-1 seropositive men. J Reprod Immunol 41(1–2):27–40. S0165-0378(98)00047-3 [pii]PubMedCrossRef Dulioust E, Tachet A, De Almeida M, Finkielsztejn L, Rivalland S, Salmon D, Sicard D, Rouzioux C, Jouannet P (1998) Detection of HIV-1 in seminal plasma and seminal cells of HIV-1 seropositive men. J Reprod Immunol 41(1–2):27–40. S0165-0378(98)00047-3 [pii]PubMedCrossRef
7.
go back to reference Barroso PF, Schechter M, Gupta P, Melo MF, Vieira M, Murta FC, Souza Y, Harrison LH (2000) Effect of antiretroviral therapy on HIV shedding in semen. Ann Intern Med 133(4):280–284. doi:200008150-00012 PubMed Barroso PF, Schechter M, Gupta P, Melo MF, Vieira M, Murta FC, Souza Y, Harrison LH (2000) Effect of antiretroviral therapy on HIV shedding in semen. Ann Intern Med 133(4):280–284. doi:200008150-00012 PubMed
8.
go back to reference Taylor S, Ferguson NM, Cane PA, Anderson RM, Pillay D (2001) Dynamics of seminal plasma HIV-1 decline after antiretroviral treatment. AIDS 15(3):424–426PubMedCrossRef Taylor S, Ferguson NM, Cane PA, Anderson RM, Pillay D (2001) Dynamics of seminal plasma HIV-1 decline after antiretroviral treatment. AIDS 15(3):424–426PubMedCrossRef
9.
go back to reference Leruez-Ville M, de Almeida M, Tachet A, Dulioust E, Guibert J, Mandelbrot L, Salmon D, Jouannet P, Rouzioux C (2002) Assisted reproduction in HIV-1-serodifferent couples: the need for viral validation of processed semen. AIDS 16(17):2267–2273PubMedCrossRef Leruez-Ville M, de Almeida M, Tachet A, Dulioust E, Guibert J, Mandelbrot L, Salmon D, Jouannet P, Rouzioux C (2002) Assisted reproduction in HIV-1-serodifferent couples: the need for viral validation of processed semen. AIDS 16(17):2267–2273PubMedCrossRef
10.
go back to reference Bujan L, Daudin M, Matsuda T, Righi L, Thauvin L, Berges L, Izopet J, Berrebi A, Massip P, Pasquier C (2004) Factors of intermittent HIV-1 excretion in semen and efficiency of sperm processing in obtaining spermatozoa without HIV-1 genomes. AIDS 18(5):757–766. 00002030-200403260-00006 [pii]PubMedCrossRef Bujan L, Daudin M, Matsuda T, Righi L, Thauvin L, Berges L, Izopet J, Berrebi A, Massip P, Pasquier C (2004) Factors of intermittent HIV-1 excretion in semen and efficiency of sperm processing in obtaining spermatozoa without HIV-1 genomes. AIDS 18(5):757–766. 00002030-200403260-00006 [pii]PubMedCrossRef
11.
go back to reference Gupta P, Leroux C, Patterson BK, Kingsley L, Rinaldo C, Ding M, Chen Y, Kulka K, Buchanan W, McKeon B, Montelaro R (2000) Human immunodeficiency virus type 1 shedding pattern in semen correlates with the compartmentalization of viral Quasi species between blood and semen. J Infect Dis 182(1):79–87. doi:10.1086/315644 PubMedCrossRef Gupta P, Leroux C, Patterson BK, Kingsley L, Rinaldo C, Ding M, Chen Y, Kulka K, Buchanan W, McKeon B, Montelaro R (2000) Human immunodeficiency virus type 1 shedding pattern in semen correlates with the compartmentalization of viral Quasi species between blood and semen. J Infect Dis 182(1):79–87. doi:10.​1086/​315644 PubMedCrossRef
12.
go back to reference Zhang H, Dornadula G, Beumont M, Livornese L Jr, Van Uitert B, Henning K, Pomerantz RJ (1998) Human immunodeficiency virus type 1 in the semen of men receiving highly active antiretroviral therapy. N Engl J Med 339(25):1803–1809. doi:10.1056/nejm199812173392502 PubMedCrossRef Zhang H, Dornadula G, Beumont M, Livornese L Jr, Van Uitert B, Henning K, Pomerantz RJ (1998) Human immunodeficiency virus type 1 in the semen of men receiving highly active antiretroviral therapy. N Engl J Med 339(25):1803–1809. doi:10.​1056/​nejm199812173392​502 PubMedCrossRef
13.
go back to reference Dornadula G, Zhang H, VanUitert B, Stern J, Livornese L Jr, Ingerman MJ, Witek J, Kedanis RJ, Natkin J, DeSimone J, Pomerantz RJ (1999) Residual HIV-1 RNA in blood plasma of patients taking suppressive highly active antiretroviral therapy. JAMA 282(17):1627–1632. joc91532 [pii]PubMedCrossRef Dornadula G, Zhang H, VanUitert B, Stern J, Livornese L Jr, Ingerman MJ, Witek J, Kedanis RJ, Natkin J, DeSimone J, Pomerantz RJ (1999) Residual HIV-1 RNA in blood plasma of patients taking suppressive highly active antiretroviral therapy. JAMA 282(17):1627–1632. joc91532 [pii]PubMedCrossRef
14.
go back to reference Semprini AE (1993) Insemination of HIV-negative women with processed semen of HIV-positive partners. Lancet 341(8856):1343–1344PubMedCrossRef Semprini AE (1993) Insemination of HIV-negative women with processed semen of HIV-positive partners. Lancet 341(8856):1343–1344PubMedCrossRef
15.
go back to reference Marina S, Marina F, Alcolea R, Expósito R, Huguet J, Nadal J, Vergés A (1998) Human immunodeficiency virus type 1-serodiscordant couples can bear healthy children after undergoing intrauterine insemination. Fertil Steril 70(1):35–39. S0015-0282(98)00102-2 [pii]PubMedCrossRef Marina S, Marina F, Alcolea R, Expósito R, Huguet J, Nadal J, Vergés A (1998) Human immunodeficiency virus type 1-serodiscordant couples can bear healthy children after undergoing intrauterine insemination. Fertil Steril 70(1):35–39. S0015-0282(98)00102-2 [pii]PubMedCrossRef
16.
go back to reference Bujan L, Pasquier C, Labeyrie E, Lanusse-Crousse P, Morucci M, Daudin M (2004) Insemination with isolated and virologically tested spermatozoa is a safe way for human immunodeficiency type 1 virus-serodiscordant couples with an infected male partner to have a child. Fertil Steril 82(4):857–862. doi:10.1016/j.fertnstert.2004.02.128 PubMedCrossRef Bujan L, Pasquier C, Labeyrie E, Lanusse-Crousse P, Morucci M, Daudin M (2004) Insemination with isolated and virologically tested spermatozoa is a safe way for human immunodeficiency type 1 virus-serodiscordant couples with an infected male partner to have a child. Fertil Steril 82(4):857–862. doi:10.​1016/​j.​fertnstert.​2004.​02.​128 PubMedCrossRef
17.
go back to reference Garrido N, Meseguer M, Simon C, Pellicer A, Remohi J (2004) Assisted reproduction in HIV and HCV infected men of serodiscordant couples. Arch Androl 50(2):105–111. L08VW6L2GRQWQGMV [pii]PubMed Garrido N, Meseguer M, Simon C, Pellicer A, Remohi J (2004) Assisted reproduction in HIV and HCV infected men of serodiscordant couples. Arch Androl 50(2):105–111. L08VW6L2GRQWQGMV [pii]PubMed
18.
go back to reference Nicopoullos JD, Almeida PA, Ramsay JW, Gilling-Smith C (2004) The effect of human immunodeficiency virus on sperm parameters and the outcome of intrauterine insemination following sperm washing. Hum Reprod 19(10):2289–2297. doi:10.1093/humrep/deh426 PubMedCrossRef Nicopoullos JD, Almeida PA, Ramsay JW, Gilling-Smith C (2004) The effect of human immunodeficiency virus on sperm parameters and the outcome of intrauterine insemination following sperm washing. Hum Reprod 19(10):2289–2297. doi:10.​1093/​humrep/​deh426 PubMedCrossRef
19.
go back to reference Moyle G (2004) Mitochondrial toxicity: myths and facts. J HIV Ther 9(2):45–47PubMed Moyle G (2004) Mitochondrial toxicity: myths and facts. J HIV Ther 9(2):45–47PubMed
20.
go back to reference Crittenden JA, Handelsman DJ, Stewart GJ (1992) Semen analysis in human immunodeficiency virus infection. Fertil Steril 57(6):1294–1299PubMed Crittenden JA, Handelsman DJ, Stewart GJ (1992) Semen analysis in human immunodeficiency virus infection. Fertil Steril 57(6):1294–1299PubMed
21.
go back to reference Dondero F, Rossi T, D’Offizi G, Mazzilli F, Rosso R, Sarandrea N, Pinter E, Aiuti F (1996) Semen analysis in HIV seropositive men and in subjects at high risk for HIV infection. Hum Reprod 11(4):765–768PubMed Dondero F, Rossi T, D’Offizi G, Mazzilli F, Rosso R, Sarandrea N, Pinter E, Aiuti F (1996) Semen analysis in HIV seropositive men and in subjects at high risk for HIV infection. Hum Reprod 11(4):765–768PubMed
22.
go back to reference Dulioust E, Du AL, Costagliola D, Guibert J, Kunstmann JM, Heard I, Juillard JC, Salmon D, Leruez-Ville M, Mandelbrot L, Rouzioux C, Sicard D, Zorn JR, Jouannet P, De Almeida M (2002) Semen alterations in HIV-1 infected men. Hum Reprod 17(8):2112–2118PubMedCrossRef Dulioust E, Du AL, Costagliola D, Guibert J, Kunstmann JM, Heard I, Juillard JC, Salmon D, Leruez-Ville M, Mandelbrot L, Rouzioux C, Sicard D, Zorn JR, Jouannet P, De Almeida M (2002) Semen alterations in HIV-1 infected men. Hum Reprod 17(8):2112–2118PubMedCrossRef
23.
go back to reference Muller CH, Coombs RW, Krieger JN (1998) Effects of clinical stage and immunological status on semen analysis results in human immunodeficiency virus type 1-seropositive men. Andrologia 30(Suppl 1):15–22PubMed Muller CH, Coombs RW, Krieger JN (1998) Effects of clinical stage and immunological status on semen analysis results in human immunodeficiency virus type 1-seropositive men. Andrologia 30(Suppl 1):15–22PubMed
24.
go back to reference Krieger JN, Coombs RW, Collier AC, Koehler JK, Ross SO, Chaloupka K, Murphy VL, Corey L (1991) Fertility parameters in men infected with human immunodeficiency virus. J Infect Dis 164(3):464–469PubMedCrossRef Krieger JN, Coombs RW, Collier AC, Koehler JK, Ross SO, Chaloupka K, Murphy VL, Corey L (1991) Fertility parameters in men infected with human immunodeficiency virus. J Infect Dis 164(3):464–469PubMedCrossRef
25.
go back to reference Brinkman K, ter Hofstede HJ, Burger DM, Smeitink JA, Koopmans PP (1998) Adverse effects of reverse transcriptase inhibitors: mitochondrial toxicity as common pathway. AIDS 12(14):1735–1744PubMedCrossRef Brinkman K, ter Hofstede HJ, Burger DM, Smeitink JA, Koopmans PP (1998) Adverse effects of reverse transcriptase inhibitors: mitochondrial toxicity as common pathway. AIDS 12(14):1735–1744PubMedCrossRef
26.
go back to reference Carr A, Miller J, Law M, Cooper DA (2000) A syndrome of lipoatrophy, lactic acidemia and liver dysfunction associated with HIV nucleoside analogue therapy: contribution to protease inhibitor-related lipodystrophy syndrome. AIDS 14(3):F25–F32PubMedCrossRef Carr A, Miller J, Law M, Cooper DA (2000) A syndrome of lipoatrophy, lactic acidemia and liver dysfunction associated with HIV nucleoside analogue therapy: contribution to protease inhibitor-related lipodystrophy syndrome. AIDS 14(3):F25–F32PubMedCrossRef
27.
go back to reference Bujan L, Sergerie M, Moinard N, Martinet S, Porte L, Massip P, Pasquier C, Daudin M (2007) Decreased semen volume and spermatozoa motility in HIV-1-infected patients under antiretroviral treatment. J Androl 28(3):444–452. doi:10.2164/jandrol.106.001529 CrossRef Bujan L, Sergerie M, Moinard N, Martinet S, Porte L, Massip P, Pasquier C, Daudin M (2007) Decreased semen volume and spermatozoa motility in HIV-1-infected patients under antiretroviral treatment. J Androl 28(3):444–452. doi:10.​2164/​jandrol.​106.​001529 CrossRef
28.
go back to reference Garrido N, Meseguer M, Remohí J, Simón C, Pellicer A (2005) Semen characteristics in human immunodeficiency virus (HIV)- and hepatitis C (HCV)-seropositive males: predictors of the success of viral removal after sperm washing. Hum Reprod 20(4):1028–1034. doi:deh699[pii]10.1093/humrep/deh699 PubMedCrossRef Garrido N, Meseguer M, Remohí J, Simón C, Pellicer A (2005) Semen characteristics in human immunodeficiency virus (HIV)- and hepatitis C (HCV)-seropositive males: predictors of the success of viral removal after sperm washing. Hum Reprod 20(4):1028–1034. doi:deh699[pii]10.​1093/​humrep/​deh699 PubMedCrossRef
32.
go back to reference Robbins WA, Witt KL, Haseman JK, Dunson DB, Troiani L, Cohen MS, Hamilton CD, Perreault SD, Libbus B, Beyler SA, Raburn DJ, Tedder ST, Shelby MD, Bishop JB (2001) Antiretroviral therapy effects on genetic and morphologic end points in lymphocytes and sperm of men with human immunodeficiency virus infection. J Infect Dis 184(2):127–135. doi:10.1086/322002 PubMedCrossRef Robbins WA, Witt KL, Haseman JK, Dunson DB, Troiani L, Cohen MS, Hamilton CD, Perreault SD, Libbus B, Beyler SA, Raburn DJ, Tedder ST, Shelby MD, Bishop JB (2001) Antiretroviral therapy effects on genetic and morphologic end points in lymphocytes and sperm of men with human immunodeficiency virus infection. J Infect Dis 184(2):127–135. doi:10.​1086/​322002 PubMedCrossRef
33.
go back to reference Folgerø T, Bertheussen K, Lindal S, Torbergsen T, Oian P (1993) Mitochondrial disease and reduced sperm motility. Hum Reprod 8(11):1863–1868PubMed Folgerø T, Bertheussen K, Lindal S, Torbergsen T, Oian P (1993) Mitochondrial disease and reduced sperm motility. Hum Reprod 8(11):1863–1868PubMed
34.
go back to reference Ruiz-Pesini E, Diez C, Lapeña AC, Pérez-Martos A, Montoya J, Alvarez E, Arenas J, López-Pérez MJ (1998) Correlation of sperm motility with mitochondrial enzymatic activities. Clin Chem 44(8 Pt 1):1616–1620PubMed Ruiz-Pesini E, Diez C, Lapeña AC, Pérez-Martos A, Montoya J, Alvarez E, Arenas J, López-Pérez MJ (1998) Correlation of sperm motility with mitochondrial enzymatic activities. Clin Chem 44(8 Pt 1):1616–1620PubMed
35.
go back to reference May-Panloup P, Chrétien MF, Savagner F, Vasseur C, Jean M, Malthièry Y, Reynier P (2003) Increased sperm mitochondrial DNA content in male infertility. Hum Reprod 18(3):550–556PubMedCrossRef May-Panloup P, Chrétien MF, Savagner F, Vasseur C, Jean M, Malthièry Y, Reynier P (2003) Increased sperm mitochondrial DNA content in male infertility. Hum Reprod 18(3):550–556PubMedCrossRef
37.
38.
go back to reference Brinkman K, Smeitink JA, Romijn JA, Reiss P (1999) Mitochondrial toxicity induced by nucleoside-analogue reverse-transcriptase inhibitors is a key factor in the pathogenesis of antiretroviral-therapy-related lipodystrophy. Lancet 354(9184):1112–1115. doi:10.1016/S0140-6736(99)06102-4 PubMedCrossRef Brinkman K, Smeitink JA, Romijn JA, Reiss P (1999) Mitochondrial toxicity induced by nucleoside-analogue reverse-transcriptase inhibitors is a key factor in the pathogenesis of antiretroviral-therapy-related lipodystrophy. Lancet 354(9184):1112–1115. doi:10.​1016/​S0140-6736(99)06102-4 PubMedCrossRef
39.
go back to reference Casula M, Weverling GJ, Wit FW, Timmermans EC, Stek M Jr, Lange JM, Reiss P (2005) Mitochondrial DNA and RNA increase in peripheral blood mononuclear cells from HIV-1-infected patients randomized to receive stavudine-containing or stavudine-sparing combination therapy. J Infect Dis 192(10):1794–1800. doi:10.1086/497140 PubMedCrossRef Casula M, Weverling GJ, Wit FW, Timmermans EC, Stek M Jr, Lange JM, Reiss P (2005) Mitochondrial DNA and RNA increase in peripheral blood mononuclear cells from HIV-1-infected patients randomized to receive stavudine-containing or stavudine-sparing combination therapy. J Infect Dis 192(10):1794–1800. doi:10.​1086/​497140 PubMedCrossRef
40.
go back to reference Phenix BN, Angel JB, Mandy F, Kravcik S, Parato K, Chambers KA, Gallicano K, Hawley-Foss N, Cassol S, Cameron DW, Badley AD (2000) Decreased HIV-associated T cell apoptosis by HIV protease inhibitors. AIDS Res Hum Retroviruses 16(6):559–567. doi:10.1089/088922200308972 PubMedCrossRef Phenix BN, Angel JB, Mandy F, Kravcik S, Parato K, Chambers KA, Gallicano K, Hawley-Foss N, Cassol S, Cameron DW, Badley AD (2000) Decreased HIV-associated T cell apoptosis by HIV protease inhibitors. AIDS Res Hum Retroviruses 16(6):559–567. doi:10.​1089/​088922200308972 PubMedCrossRef
41.
go back to reference Sloand EM, Kumar PN, Kim S, Chaudhuri A, Weichold FF, Young NS (1999) Human immunodeficiency virus type 1 protease inhibitor modulates activation of peripheral blood CD4(+) T cells and decreases their susceptibility to apoptosis in vitro and in vivo. Blood 94(3):1021–1027PubMed Sloand EM, Kumar PN, Kim S, Chaudhuri A, Weichold FF, Young NS (1999) Human immunodeficiency virus type 1 protease inhibitor modulates activation of peripheral blood CD4(+) T cells and decreases their susceptibility to apoptosis in vitro and in vivo. Blood 94(3):1021–1027PubMed
Metadata
Title
HIV-infection and modern antiretroviral therapy impair sperm quality
Authors
Sven Kehl
Michael Weigel
Daniel Müller
Monika Gentili
Amadeus Hornemann
Marc Sütterlin
Publication date
01-07-2011
Publisher
Springer-Verlag
Published in
Archives of Gynecology and Obstetrics / Issue 1/2011
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-011-1898-6

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