HCV-RNA detection in different fractions of HCV/HIV-1 co-infected men by nested PCR

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

Study question: Do HIV-1 infection and antiretroviral therapy affect semen parameters and sperm DNA integrity? Summary answer: A significant proportion of HIV-1 infected patients had semen values below the 5\ub0 percentile of the WHO 2010 reference group; sperm nuclear fragmentation rate was significantly increased in HIV-1 infected patients taking antiretroviral therapy compared with na\uefve HIV-1 infected patients. What is known already: HIV-1 infection may affect semen parameters, such as motility, sperm concentration, or total sperm count. HAART (highly active antiretroviral therapy) could change spermatozoa metabolism due to mitochondria damage that, in turn, may be responsible for the reduction of their motility and fertilization competence. Study design, size, duration: For the first aim of the study, we assessed the potential effects of HIV-1 infection on semen parameters and we retrospectively analyzed semen samples obtained from 770 HIV-1 patients under stable antiretroviral therapy. For the second aim of the study, we evaluated the effects of HAART on sperm DNA fragmentation and we designed a case-control prospective study, comparing semen samples of HIV-1 infected patients receiving HAART (n. 51) versus na\uefve HIV-1 infected patients (n. 24). For both purposes of the study patients were recruited between January 2010 and June 2015 in our Assisted Reproduction Unit in Hospital \u201cL. Sacco\u201d (University of Milan, Italy) and all patients were asking reproductive assistance with their HIV negative partner. Participants/materials, setting, methods: Objective 1: 770 HIV-1 patients, under stable antiretroviral therapy. 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. Objective 2: 51 HIV-1 infected patients taking antiretroviral therapy (HAART) vs. 24 HIV-1 infected patients not receiving antiretroviral therapy. Sperm DNA fragmentation and semen analysis was performed using chromatin dispersion test (SCD). For both purposes of the study, all the patients did not present any clinical sign of their disease. Main results and the role of chance: Median values of all assessed semen parameters were significantly lower in HIV-1 infected patients 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\ub0 percentile of the WHO 2010 reference group (p< 0.05). Sperm DNA fragmentation rate was significantly increased in HIV-1 infected patients taking antiretroviral therapy (68.65%) compared with the group of HIV-1 infected patients not receiving antiretroviral therap

Should HCV chronic infection impairer male fertility?

BACKGROUD: It is estimated that about 3% of world population is affected by HCV virus. Most of affected male is during reproductive age. The sexual way of infection is doubtful even now. It is estimated that HCV RNA is presented in semen in 11% - 31.6% of cases. HCV RNA has been found in semen plasma and in not-spermatic cells, but not in sperm before and after swim-up. Aim of our study is to evaluate the HCV patients\u2019 semen parameters compared to WHO 2010 semen parameters. MATERIALS AND METHODS: It is an observational study that include 58 patients following by our Fertility Center located in Luigi Sacco Hospital, in Milan, during 2010 to 2015. This patients\u2019 group was affected by HCV chronic infection, nobody had hepatitis B, HIV or genital infections. All semen analysis was performed by the same biologist and in the same laboratory, after 3-5 days of sexual abstinence. RESULTS: Population\u2019s study characteristics are described in the table 1. Patients 58 Age 43\ub16 Virus values 4810174 (range 1020-36091104) Way of infectious Unknown 58 (100%) TABLE 1 Table 2 shows results of comparison between patients HVC RNA positive and WHO fertile reference group. HCV male group presents median semen parameters significant lower than median semen parameters according to WHO 2010 values. About 50% of HCV patients have morphology\u2019 and motility\u2019s values below the fifth percentile of WHO reference values. Semen parameters HCV patients (n=58) Lower limit parameter WHO Population WHO Patients (%) Outside reference WHO parameter P value Volume (ml) 2,5 (0,5-6) 1,5 3,7 34,5 <0,05 Sperm concentration (10\u2076/ml) 24,5 (0-123) 15 73 27,6 <0,05 Total sperm count (10\u2076) 54,5 (0-297,5) 39 255 32,8 <0,05 Progressive Motility 34(0-60) 32 55 48,3 <0,05 Normal Morphology (%) 5 (1-27) 4 15 50 <0,05 TABLE 2 CONCLUSION: Our study provides evidence that all semen parameters of HVC-positive men are impaired comparing to WHO 2010 reference values and therefore a possible altered fertility in this group. Oxidative stress as a host response to HCV core protein and reactive oxidative species produced could damage sperm DNA and alter sperm quality. Concluding our Fertility center strongly suggests reproductive counselling in all couples with HCV male partner who desire a pregnancy