Viral infections among couples for assisted reproduction in a fertility clinic in Nigeria.

CONTEXT

The risk of laboratory cross-contamination may limit the availability of assisted conception for couples infected with chronic viruses. However, assisted conception is the standard of care for people living with human immunodeficiency virus (HIV) to minimize risk of transmission or reinfection.

AIMS

To assess the burden of viral infection among couples that present for assisted reproductive technology (ART) with a view to evaluating implications for their care.

SETTINGS AND DESIGN

A cross-sectional descriptive study carried out among 138 couples at a private fertility clinic in Nigeria.

MATERIALS AND METHODS

Screening for HIV, hepatitis B virus (HBV) and hepatitis C virus were carried out among these clients. The males' seminal parameters were analyzed according to World Health Organization (WHO) criteria.

STATISTICAL ANALYSIS USED

Statistical Package for Social Sciences was employed. Analysis was by Chi-square test; statistical significance was set at 0.05.

RESULTS

Viral infections were found in 10/138 women (7.2%) and 15/138 (10.9%) men. The most prevalent infection was HBV. Twenty-one couples were sero-discordant. Two couples had concordant HIV and HBV infections, respectively. There was no significant association between sperm quality and chronic hepatitis infection.

CONCLUSION

Nearly a fifth of the couples had at least one partner infected with a chronic virus - a proportion significant enough to demand attention. Apart from separate laboratory and storage facilities, basic principles to minimize transmission are recommended: HBV vaccination in sero-discordant partners of HBV carriers (and immunoprophylaxis for the baby) and antiretroviral therapy for HIV-positive partners to reduce the viral load before fertility treatment is commenced.