Effect of antiretroviral drugs on the quality of semen

Abstract

The aim of this cross-sectional study was to determine which antiretroviral drugs (ARVs) are associated with changes in the characteristics of semen and the impact of these ARVs according to their score penetration into the male genital compartment. Data from 144 men infected with HIV-1 enrolled in an Assisted Reproductive Technology program were analyzed retrospectively. A seminal penetration score of ARV was based on the available literature. The nonparametric Kruskal-Wallis test and chi-square test were used. There was no difference on sperm parameters between NRTI, NNRTI, or PI regimen. In patients receiving NRTIs or PIs no differences were observed between antiretrovirals of these classes. However, in patients receiving NNRTIs, nevirapine (n = 22) was associated with a higher percentage of progressively motile spermatozoa (P < 0.0001) versus efavirenz (n = 38) as well as vitality (P = 0.0004). No relationship was observed between semen quality and the penetration score. NRTIs and PIs were not associated with any semen changes. Nevirapine was associated with a better quality of semen versus efavirenz. It would be of interest to validate, improve and test our penetration score in a prospective study.

Once‐daily darunavir/ritonavir 400/100 mg in triple therapy: efficacy and penetration in seminal compartment in ANRS‐165 DARULIGHT study

“…The ratio of seminal plasma total/blood plasma unbound DRV C min was 1.39 (1.14-2.71). Furthermore, blood and seminal plasma total DRV C min were correlated (r = 0.718) and consistent with previous data [9,10]. These results suggest that the unbound fraction of DRV well penetrated the semen and that the seminal concentration of DRV can be predicted from blood plasma total DRV C min .…”

Comparison of Antioxidant Effects of Kolaviron and Vitamin C Interventions on Testicular Structures Following Nevirapine Administration in Sprague-Dawley Rats

“…Nevirapine, a NNRTI, has been used as a first-line antiretroviral treatment regime with positive success (Podzamcer & Fumero, 2001) but unwanted adverse hepatotoxicity (Kontorinis & Dieterich, 2003) is repleted. This is in addition to reported spermiotoxic effects related to reduction in sperm motility and viability with necrosis of spermatids in experimental (Adaramoye et al, 2005) and cross-sectional study of human semen samples (Lambert-Niclot et al, 2011).…”

Compartmentalization and Antiviral Effect of Efavirenz Metabolites in Blood Plasma, Seminal Plasma, and Cerebrospinal Fluid

“…Subsequently, toxicity of 8-OH EFV to dendritic cells of the CNS has also been reported (Tovar-y-Romo et al, 2012). Although the mechanisms underlying the adverse effects of EFV on semen quality have yet to be fully elucidated, it has been reported that treatment with EFV results in decreased motile spermatozoa and vitality, suggested to be the result of mitochondrial toxicity or direct toxicity to the cells producing spermatozoa (van Leeuwen et al, 2008;Lambert-Niclot et al, 2011). Because 8-OH EFV has been reported to play a causal role in certain compartment-specific toxicities (Bumpus, 2011;Tovar-y-Romo et al, 2012), understanding the clinical exposure of monohydroxylated and dihydroxylated metabolites of EFV is of importance.…”