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M9460696.TXT
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1994-06-25
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Document 0696
DOCN M9460696
TI The effects of disease progression and zidovudine therapy on semen
quality in human immunodeficiency virus type 1 seropositive men.
DT 9408
AU Politch JA; Mayer KH; Abbott AF; Anderson DJ; Fearing Research
Laboratory, Department of Obstetrics,; Gynecology, and Reproductive
Biology, Brigham and Women's; Hospital, Harvard Medical School, Boston,
Massachusetts.
SO Fertil Steril. 1994 May;61(5):922-8. Unique Identifier : AIDSLINE
MED/94229271
AB OBJECTIVE: To investigate the effects of disease progression and
zidovudine antiretroviral therapy on semen parameters in human
immunodeficiency virus type 1 (HIV-1) seropositive men. DESIGN:
Cross-sectional analysis of semen parameters of 166 HIV-1 seropositive
men in various stages of disease progression as defined by peripheral
CD4+ cell count. Clinical symptoms and zidovudine therapy status were
obtained from medical records and clinical interviews. PATIENTS: Human
immunodeficiency virus type 1 seropositive men participating in clinical
studies at the Fenway Community Health Center (Boston, MA), the
University of San Francisco (San Francisco, CA), and Brown University
(Providence, RI). MAIN OUTCOME MEASURES: Ejaculate volume; sperm
concentration, motility, forward progression, morphology, total sperm
count; seminal immature germ cell; and white blood cell (WBC)
concentrations. RESULTS: Human immunodeficiency virus type 1
seropositive men that were not on zidovudine therapy and were in early
disease stage (> 200 CD4+ cells/mm3) had normal semen parameters as
defined by World Health Organization criteria. In contrast untreated men
in advanced disease stage (< or = 200 CD4+ cells/mm3) had significant
reductions in sperm concentration and total sperm count and an increased
percentage of abnormal sperm forms. Men receiving zidovudine
antiretroviral therapy, regardless of disease stage, had normal semen
parameters similar to those of untreated early disease stage patients.
Seminal WBC concentrations were not affected significantly by disease
progression but were reduced in patients receiving zidovudine.
CONCLUSION: Most HIV-1-infected men in this study had semen parameters
consistent with fertility. Disease progression was associated with
reduced semen quality, but this effect appeared to be abrogated by
zidovudine therapy. Zidovudine was also associated with a significant
reduction of WBC numbers in semen. As seminal WBC are principal HIV-1
host cells in ejaculates of HIV-1-infected men, this effect could
explain recent laboratory and epidemiological evidence that zidovudine
therapy is associated with a reduced prevalence of HIV-1 in semen and a
lower rate of sexual transmission.
DE Acquired Immunodeficiency Syndrome/*DRUG THERAPY/EPIDEMIOLOGY/
*PHYSIOPATHOLOGY Adult Comparative Study Cross-Sectional Studies
Human HIV Seropositivity/*DRUG THERAPY/EPIDEMIOLOGY/*PHYSIOPATHOLOGY
HIV-1/*IMMUNOLOGY Leukocytes/PATHOLOGY/PHYSIOLOGY Male Middle Age
Semen/DRUG EFFECTS/*PHYSIOLOGY Severity of Illness Index Sperm
Count/DRUG EFFECTS Sperm Motility/DRUG EFFECTS/PHYSIOLOGY
Spermatozoa/DRUG EFFECTS/PATHOLOGY/PHYSIOLOGY Support, U.S. Gov't,
P.H.S. Zidovudine/*THERAPEUTIC USE JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).