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15th Annual Conference of the British HIV Association1-3 April 2009, Liverpool, UK |
A DECADE OF THE SPERM-WASHING PROGRAM: THE EFFECT OF HIV ON SEMEN PARAMETERS AND VIRAL LOAD?
HIV Med 2009 Apr 1-3 (Suppl 1);15:7 (abstract no. O8)
JDM Nicopoullos, P Almeida and C Gilling-Smith
Chelsea & Westminster NHS Trust, London, UK
BACKGROUND: The Chelsea and Westminster ACU has treated HIV-positive men with ‘sperm washing’ as risk-reduction since 1999. We use a decade of experience to assess the effect of HIV disease on semen parameters and highlight the continuing importance of risk-reduction with sperm-washing when some controversially advocate the safety of timed unprotected intercourse for conception in the ‘stable’ HIV-positive man.
METHODS: Three hundred and fifty-eight fresh samples used for spermwashing/IUI were correlated against markers of HIV disease (CD4 count, viral load, duration of HIV infection and use of antiretroviral therapy) and to assess the risk of detectable virus in semen.
RESULTS: A significant positive correlation was observed between CD4 count and total sperm count, progressive motility, post-preparation/insemination concentration, progressive motility and total motile count inseminated (TMCI) and a significant negative correlation was observed between CD4 and normal sperm morphology (Spearman’s correlation; P<0.05). There was no significant difference in any parameter according to whether VL was detectable/undetectable. The use of HAART significantly decreased total count, progressive motility, post-preparation count and TMCI and significantly increased abnormal forms (Mann-Whitney tests; P<0.05). There was a significant negative correlation between duration of HAART use and concentration, total count and post-preparation motility and between years since diagnosis and post-preparation motility. Paradoxically, a positive correlation was observed between raw progressive motility and both years since diagnosis and on medication. In 9.7% of IUI cycles performed with fresh sperm in men on HAART with undetectable VL, detectable HIV was found in either pre or post wash seminal samples.
CONCLUSIONS: Our data suggests a negative effect of low CD4 count and the use of HAART on semen. The significant proportion of 'stable' men with undetectable serum viral load but virus in semen confirms the continued importance of such risk-reduction measures.
2009-04-01
O8
Copyright © 2009 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD