Department of Urology, Santa Chiara Regional Hospital, Trento, Italy.
BJU Int. 2014 Feb;113(2):281-7. doi: 10.1111/bju.12244. Epub 2013 Jul 26.
To investigate the effect of human papillomavirus (HPV) and Chlamydia trachomatis (Ct) co-infection on sperm concentration, motility and morphology, in a large cohort of young heterosexual male patients with chronic prostatitis-related symptoms.
Patients with chronic prostatitis-related symptoms, attending the same centre for sexually transmitted diseases from January 2005 and December 2010, were consecutively enrolled in this cross-sectional study. All patients underwent clinical and instrumental examination, microbiological cultures for common bacteria, DNA extraction, mucosal and serum antibodies evaluation for Ct, specific tests for HPV and semen analysis. The semen variables analysed were: volume; pH; sperm concentration; motility; and morphology. Subjects were subdivided in two groups: group A, patients with Ct infection alone and group B, patients with Ct and HPV co-infection. The main outcome measurement was the effect of Ct and HPV co-infection on the semen variables examined.
Of 3050 screened patients, 1003 were enrolled (32.9%) in the study. A total of 716 (71.3%) patients were allocated to group A, and 287 (28.7%) to group B. Significant differences between the two groups were reported in terms of percentage of motile sperm (degrees of freedom [df] = 1001; t-test = 11.85; P < 0.001) and percentage of normal morphological forms (df = 1001; t-test = 7.18; P < 0.001), while no differences were reported in terms of semen volume or pH. According to World Health Organization thresholds for normal semen, 364 (50.8%) men in group A and 192 (66.8%) men in group B were subfertile (odds ratio = 1.95; 95% confidence interval 1.46-2.60; P < 0.001). No correlation between HPV genotype, mucosal IgA type and semen variables was found.
In a population of prostatitis-related symptoms attributable to Ct infection, co-infection with HPV has a significant role in decreasing male fertility, in particular with regard to sperm motility and morphology.
研究人乳头瘤病毒（HPV）和沙眼衣原体（Ct）合并感染对慢性前列腺炎相关症状的大量年轻异性恋男性患者的精子浓度、活力和形态的影响。
本横断面研究连续纳入 2005 年 1 月至 2010 年 12 月期间在同一性病中心就诊的慢性前列腺炎相关症状患者。所有患者均接受了临床和仪器检查、常见细菌的微生物培养、DNA 提取、Ct 的黏膜和血清抗体评估、HPV 的特定检测和精液分析。分析的精液变量包括：体积；pH 值；精子浓度；活力；形态。将受试者分为两组：A 组为 Ct 感染患者，B 组为 Ct 和 HPV 合并感染患者。主要观察指标是 Ct 和 HPV 合并感染对所检查的精液变量的影响。
在筛选出的 3050 名患者中，有 1003 名（32.9%）纳入本研究。共有 716 名（71.3%）患者被分配到 A 组，287 名（28.7%）患者被分配到 B 组。两组之间在运动精子百分比（自由度[df] = 1001；t 检验= 11.85；P < 0.001）和正常形态百分比（df = 1001；t 检验= 7.18；P < 0.001）方面存在显著差异，而精液体积或 pH 值方面无差异。根据世界卫生组织正常精液阈值，A 组中有 364 名（50.8%）男性和 B 组中有 192 名（66.8%）男性患有不育症（比值比= 1.95；95%置信区间 1.46-2.60；P < 0.001）。未发现 HPV 基因型、黏膜 IgA 类型与精液变量之间存在相关性。
在归因于 Ct 感染的前列腺炎相关症状人群中，HPV 合并感染对男性生育力有显著影响，特别是对精子活力和形态。
