Cytomegalovirus DNA in semen of men seeking fertility evaluation in Abidjan, Côte d’Ivoire

Abstract

Cytomegalovirus (CMV) infects humans throughout the world but is more widespread in developing countries and in areas of lower socio-economic conditions. Transmission of CMV occurs from person-to-person through close contact with infectious body fluids. Viral shedding in genital secretions is a source of sexually transmitted infections. The prevalence of CMV in semen has been investigated in several countries in studies conducted among sperm donors [1, 2] or among men seeking fertility evaluation [3, 4]. However, no data have been reported from Africa to date. In the study presented here, the presence of CMV DNA was investigated in consecutive semen samples obtained from 63 men seeking fertility evaluation in Abidjan, Cote d’Ivoire. The subjects had a median age of 36 years (interquartile range, 32–40 years). Semen was collected by masturbation after 3–5 days of sexual abstinence. Semen analysis for infertility evaluation was performed according to the World Health Organization (WHO) guidelines [5]. The median sperm count was 1.3×10 cells/ml (interquartile range, 1.0×10–3.6×10 cells/ml). DNA was extracted from frozen semen aliquots using the QIAmp DNA minikit (QIAgen, Courtaboeuf, France) according to the manufacturer’s instructions. Extracts were tested for the presence of amplifiable DNA and the absence of PCR inhibitors by performing beta-globin PCR [6]. CMV DNA was detected by real-time PCR using a previously described procedure [7]. Nine (14.3%) semen samples were positive for CMV DNA. There was no difference in sperm count between men shedding (median, 1.2×10 cells/ml) or not shedding (1.45×10 cells/ml) CMV in semen ( p=0.45). Previous studies have found an overall prevalence of CMV DNA ranging from 2.9 to 8.1% in the semen of sperm donors [1, 2] or in men seeking fertility evaluation [3, 4]. The prevalence of CMV DNA in semen has been reported to be higher than that of seminal shedding identified by isolation of virus in cell culture [1, 2]. However, the detection of CMV DNA alone cannot indicate the infectious potential of semen specimens in the absence of infectious virus recovered by culture. In the present study, CMV serological status was not determined, but it is recognized that virtually all adults are seropositive for CMV in Sub-Saharan Africa. It is also well known that the frequency of CMV seminal shedding is higher in individuals infected with HIV [8]. For most of the men included in this study, the HIV serological status was unknown; however, the seroprevalence of HIV in adults (15–49 years) in Cote d’Ivoire is estimated to be higher than 4% [9]. This high prevalence might explain the higher rate of CMV DNA detection in the semen of African men as compared with men from Western countries. In agreement with previous studies, no differences in sperm count were observed between men shedding or not shedding CMV in semen. This confirms that CMV seminal shedding probably has no impact on sperm quality. Eur J Clin Microbiol Infect Dis (2007) 26:295–296 DOI 10.1007/s10096-007-0271-y