Negative effect of antiretroviral therapy on spermogram values in HIV-positive men

Abstract

The study objective is to analyze spermogram values in HIV-positive men receiving antiretroviral therapy (ART).Materials and methods. The prospective case-controlled study included 115 men: the main group consisted of 51 patients with HIV, control group consisted of 64 patients with negative serological test for HIV and normal spermogram values. In total, 97 and 111 sperm samples were analyzed. HIV status was evaluated based on disease stage and phase, viral load, CD3+, CD4+, CD8+ lymphocyte counts and ART duration.Results. History of HIV varied between 2 and 9 years (median 5 years). All patients were receiving ART. Median duration of drug administration was 1.5years. In 48.4 % of HIV-positive patients, normozoospermia was observed. In the structure of pathological zoospermia, teratozoospermia was the most prevalent (40 %), and the percentage of pathological forms of spermatozoa in HIV-positive men was significantly higher than in HIV-negative men (97 (96—98) and 96 (95—96) %, р = 0.0001, respectively). Ejaculate volume (2.7 (2.0—3.4) and 3.1 (2.3—4.0) ml, р = 0.003), total count (89.1 (47.3—153.0) and 198.8 (138.5—272.8) million, р = 0.0001), concentration (36 (21—52) and 63.5 (46—91) million/ml, р = 0.0001), percentage of progressive motile (40 (31—53) and 55 (48.7—62.2) %, р = 0.0001) and viable sperm (78 (71.5—81.0) and 84 (82—87) %, р = 0.0001) were significantly lower, and the number of immotile forms (50 (39—55.5) and 38 (31.7—42.2) %, р = 0.0001) significantly higher in HIV-positive patients than in men without HIV. Negative correlations between the number of abnormal spermatozoa and CD4+ lymphocyte count (r = —0.362, р = 0.026), disease duration and sperm concentration (r = —0.242, р = 0.020), percentage of progressive motile sperm (grade B) and disease duration (r = —0.241, р = 0.024) were established. ART duration negatively correlated with the percentage of progressive motile sperm (grade B) (r = —0.224, р = 0.036). Percentage of sperm with fragmented DNA was significantly higher in HIV-positive patients compared to HIV-negative men (15.8 (12.4—23.0) and 9.95 (7.3— 12.4) %, р = 0.001, respectively).Conclusion. In HIV-positive patients receiving ART, sperm DNA fragmentation and the number of pathological forms are increased. Percentage of abnormal forms is higher for lower CD4+ lymphocyte counts. Sperm concentration decreases, and percentage of immobile forms increases with duration of HIV infection. ART negatively affects sperm motility.

Keywords

• hiv
• antiretroviral therapy
• dna fragmentation
• fertility
• infertility
• spermogram