1. [Semen quality and HIV RNA level in HIV/AIDS male patients after treated by highly active antiretroviral therapy]
- Author
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Xun-Rong, Zhu, Ling-Hua, Li, Li-Xin, Fan, Bao-Jin, Li, Yun, Lan, Feng, Li, Shi-Ling, Zheng, Huo-Lin, Zhong, Rui-Ying, He, and Liu-Ping, Yang
- Subjects
Adult ,Male ,Sperm Count ,HIV Infections ,Flow Cytometry ,Spermatozoa ,Semen Analysis ,Young Adult ,Pregnancy ,Semen ,Antiretroviral Therapy, Highly Active ,Sperm Motility ,Humans ,RNA, Viral ,Female - Abstract
To evaluate the semen quality of the HIV/AIDS male patients after treated by the highly active antiretroviral therapy (HAART) and their potential of transmitting HIV/AIDS and provide some evidence for this cohort of males who wish for parenthood.We collected semen samples from 20 HIV/AIDS male patients who had been treated by HAART for over 6 months and wished for parenthood. We examined sperm concentration, viability and total motility and the percentage of morphologically normal sperm (MNS) using the computer-assisted semen analysis system, measured the HIV-1 RNA loads in the semen by the Cobas Amplicor Monitor test, and counted CD4+ T cells in the peripheral blood by flow cytometry.The patients were aged 25-40 (30.7 ± 5.05) years. After treated by HAART for 6-26 (14.24 ± 12.26) months, the count of blood CD4+ T cells was significantly increased (341-1 058 [535.76 ± 212.021] /μl) in comparison with the baseline (226-965 [422.38 ± 200.86] /μl). Compared with the normal value, the semen volume was increased except in 1 case (≥2 ml) while total sperm motility was decreased in 13 cases (≥40%), and so were sperm concentration in 2 cases (≥15 × 106 / ml), sperm viability in 5 (58%), the percentage of progressively motile sperm in 18 (≥32%), and the percentage of MNS in 6 (≤4%). HIV-1 RNA in the peripheral blood was20 copies/mL in all the cases and that in the seminal plasma was also20 copies/ml in 18 cases but20 copies/mL in the other 2 ([4.70 × 101] and [2.2 × 102] copies/ml, respectively). Of the 4 couples that had sex without protective measures for over 6 months, all the 4 female partners exhibited negative HIV antibodies in regular follow-up examinations and 1 achieved spontaneous pregnancy and healthy birth, with negative HIV-1 RNA in both the mother and the baby.The HIV RNA level is higher in the semen than in the blood of the HIV/AIDS male patients after HAART, which indicates the potential risk of their semen transmitting HIV/AIDS to their female partners. Their sperm concentration and total sperm motility are lower than the normal value, which suggests a decreased fertility.目的: 高效抗逆转录病毒治疗(HAART)可以显著延长HIV感染者的寿命并提高其生活质量,越来越多的男性HIV单阳的夫妻希望完成做父母的愿望,本研究通过检测HAART治疗后男性HIV/AIDS患者精液HIV-1 RNA水平与精液指标,评估潜在传播风险和精液质量,为优生优育提供依据。方法: 20例有生育要求且接受HAART超过6个月的男性HIV携带者/AIDS患者,用精子动态图像分析系统检测其精子浓度、存活率、总活力、正常形态精子百分率,用COBAS Amplicor检测精液HIV RNA载量及流式细胞仪技术计数血液CD4+ T细胞。结果: 20例患者年龄25~40(30.7±5.05)岁,接受HAART治疗6(14.24 ±12.26)个月以上,治疗前基线CD4+细胞226~965 cells/ul ( 422.38±200.86),检测时CD4+细胞341~1 058 cells/ul ( 535.76±212.02)。除1例外精液量均高于正常参考值(≥2 ml);14例患者精子总活力低于正常值(≥40%),18例患者前向运动精子百分率低于正常参考值(≥32%),2例精子浓度低于正常参考值(≥15×106/ml);有5例精子存活率低于正常参考值(58%);有6例正常形态精子百分率≤4%。20例患者外周血HIV-1 RNA均20拷贝/ml,18例精浆HIV-1RNA 也20拷贝/ml,但2例20拷贝/ml,分别为4.70×101拷贝/ml和2.2×102拷贝/ml。4例与配偶无保护措施同房超过半年,女方定期查HIV抗体均阴性,其中1例自然怀孕生育,母子HIV-1 RNA均为阴性。结论: HAART治疗后仍有部分患者精液中HIV RNA水平高于血浆中HIV RNA水平,提示精液仍可能存在少量HIV,具有潜在传染风险,因此对男性HIV感染者/AIDS患者常规检查精液HIV-1 RNA可以降低女性感染风险。同时发现,HIV感染者/AIDS患者精子总活力与浓度低于正常参考值,生育能力降低。.
- Published
- 2018