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Biological markers of fertility (inhibin‐B) in HIV ‐infected men: influence of HIV infection and antiretroviral therapy
Author(s) -
MorenoPérez O,
Boix V,
Merino E,
Picó A,
Reus S,
Alfayate R,
Giner L,
Mirete R,
SánchezPayá J,
Portilla J
Publication year - 2016
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12350
Subject(s) - medicine , human immunodeficiency virus (hiv) , antiretroviral therapy , immunology , virology , fertility , viral load , population , environmental health
Objectives Inhibin B ( IB ) levels and the IB : follicle‐stimulating hormone ( FSH ) ratio ( IFR ), biomarkers of global Sertoli cell function, show a strong relationship with male fertility. The aim of the study was to examine the prevalence of impaired fertility potential in HIV ‐infected men and the influence of antiretroviral therapy ( ART ) on fertility biomarkers. Methods A cross‐sectional study with sequential sampling was carried out. A total of 169 clinically stable patients in a cohort of HIV ‐infected men undergoing regular ambulatory assessment in a tertiary hospital were included. The mean [± standard deviation ( SD )] age of the patients was 42.6 ± 8.1 years, all were clinically stable, 61.5% had disease classified as Centers for Disease Control and Prevention ( CDC ) stage A, and were na?ve to ART or had not had any changes to ART for 6 months (91.1%). Morning baseline IB and FSH concentrations were measured using an enzyme‐linked immunosorbent assay ( ELISA ) and an electrochemiluminescent immunoassay ( ECLIA ), respectively. A multivariate logistic regression model was used to identify factors associated with impaired fertility, defined as IB < 119 pg/mL or IFR < 23.5. Results The mean (± SD ) IB level was 250 ± 103 pg/mL, the median [interquartile range ( IQR )] FSH concentration was 5.1 (3.3–7.8) UI /L and the median ( IQR ) IFR was 46.1 (26.3–83.7). The prevalence of impaired fertility was 21.9% [95% confidence interval ( CI ) 16.3–20.7%]. Negative correlations of body mass index and waist: hip ratio with FSH and IB levels were observed ( P < 0.01), while a sedentary lifestyle and previous nevirapine exposure were associated with a decreased risk of IB levels ≤ 25th percentile in multivariate analysis. Only older age, as a risk factor, and sedentary lifestyle, with a protective effect, were independently associated with impaired fertility in multivariate analysis. Conclusions Global testicular Sertoli cell function and fertility potential, assessed indirectly through serum IB levels and IB : FSH ratio, appear to be well maintained in HIV ‐infected men and not damaged by ART .