van Leeuwen Elisabeth, Wit Ferdinand W, Repping Sjoerd, Eeftinck Schattenkerk Jan Karel M, Reiss Peter, van der Veen Fulco, Prins Jan M
Centre for Reproductive Medicine, Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, the Netherlands.
AIDS. 2008 Mar 12;22(5):637-42. doi: 10.1097/QAD.0b013e3282f4de10.
To evaluate the effect of combination antiretroviral therapy (cART) on semen quality.
A longitudinal cohort study.
The HIV outpatient clinic of the Academic Medical Centre in Amsterdam, the Netherlands.
A cohort of 34 male patients with different estimated duration of HIV-1 infection, who were about to start various combinations of cART.
INTERVENTION(S): Blood and semen analyses before the start of cART and 4, 12, 24, 36 and 48 weeks thereafter.
MAIN OUTCOME MEASURE(S): We examined the effect of cART on semen parameters by a repeated measurements procedure using a mixed-effects model.
The median period of follow up was 48 weeks (interquartile range 33-52 weeks). Five patients used thymidine analogue-containing cART, 23 used tenofovir-based cART, six used other regimens. At all timepoints the percentage of progressively motile spermatozoa was low according to WHO criteria, and it decreased significantly from 28 to 17% during follow-up (P = 0.02). All other semen parameters were in the normal range and remained stable.
cART negatively affected the percentage of progressively motile spermatozoa. Whether this reduced motility affects the chances of fathering a child or leads to an increased need for artificial reproductive techniques is at present unknown.
评估联合抗逆转录病毒疗法（cART）对精液质量的影响。
一项纵向队列研究。
荷兰阿姆斯特丹学术医疗中心的艾滋病毒门诊。
一组34名男性患者，其估计的HIV-1感染持续时间各不相同，即将开始使用各种cART联合方案。
在开始cART之前以及之后的4、12、24、36和48周进行血液和精液分析。
我们使用混合效应模型通过重复测量程序研究了cART对精液参数的影响。
中位随访期为48周（四分位间距33 - 52周）。5名患者使用含胸苷类似物的cART，23名使用基于替诺福韦的cART，6名使用其他方案。根据世界卫生组织标准，在所有时间点，进行性运动精子的百分比都很低，并且在随访期间从28%显著下降至17%（P = 0.02）。所有其他精液参数均在正常范围内且保持稳定。
cART对进行性运动精子的百分比有负面影响。目前尚不清楚这种运动能力的降低是否会影响生育孩子的几率或导致对辅助生殖技术的需求增加。
