Abstract
Patients with human immunodeficiency virus type 1 (HIV-1) who receive antiretroviral therapy (ART) often achieve increased survival and improved quality of life. In this respect, monotherapy with darunavir/ritonavir (mDRV/r) can be a useful treatment strategy. This prospective study analyses the effect of mDRV/r on sperm quality and viral load in a group of 28 patients who had previously been given conventional ART and who had recorded a viral load <20 copies/mL for at least six months. These patients were given mDRV/r at a dose of 800/100 mg for 48 weeks. At baseline (V0), CD4, CD8, FSH, LH and testosterone levels were measured, together with HIV-1 viral load in plasma and semen. In addition, seminal fluid quality was studied before mDRV/r treatment was prescribed. At week 48 (V1), HIV-1 viral load in plasma and semen and the quality of the seminal fluid were again measured. The results obtained indicate that at V0, 10% of the patients with ART had a positive viral load in seminal fluid (>20 copies/ml), and that at V1, after mDRV/r treatment, this figure had fallen to 3%. The quality of seminal fluid was close to normal in 57% of patients at V0 and in 62% at V1. We conclude that, similar to ART, mDRV/r maintains HIV-1 viral load in most patients, and that there is no worsening in seminal fluid quality.
Highlights
The principal route of transmission of the human immunodeficiency virus (HIV-1) is heterosexual activity
Seminal Fluid Quality in human immunodeficiency virus type 1 (HIV-1) Monotherapy completed a course of antiretroviral therapy (ART) is close to zero (1:100000) if the plasma viral load has been undetectable during the previous six months, if the patient has adhered strictly to the ART and if no other sexually transmitted disease is present [1]
The percentage of semen samples with a positive viral load was similar in monotherapy and in tri-therapy (3% vs. 10%) and no statistically significant differences were observed (p = 0.3946)
Summary
The principal route of transmission of the human immunodeficiency virus (HIV-1) is heterosexual activity. Seminal Fluid Quality in HIV-1 Monotherapy completed a course of antiretroviral therapy (ART) is close to zero (1:100000) if the plasma viral load has been undetectable during the previous six months, if the patient has adhered strictly to the ART and if no other sexually transmitted disease is present [1]. Sexual transmission between partners is significantly reduced when the seropositive member receives highly active antiretroviral therapy (HAART) [2,3]. Some authors have observed decreased seminal fluid parameters in patients with HIV-1 [4,5,6,7], but others have found no significant differences in this respect [8]. In patients who began treatment with HAART, a reduction in the percentage of motile sperm after 48 weeks of follow-up was observed [9]. Decreased mitochondrial DNA in the sperm of patients treated with nucleoside reverse transcriptase inhibitors has been reported [10,11]
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