51. Biological markers of fertility (inhibin-B) in HIV-infected men: influence of HIV infection and antiretroviral therapy
- Author
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Rocío Alfayate, Óscar Moreno-Pérez, Esperanza Merino, Antonio Picó, Livia Giner, Vicente Boix, Sergio Reus, Joaquín Portilla, R Mirete, and José Sánchez-Payá
- Subjects
Adult ,Male ,antiretroviral treatment ,medicine.medical_specialty ,Cross-sectional study ,media_common.quotation_subject ,HIV Infections ,030209 endocrinology & metabolism ,Fertility ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,inhibin-B ,Interquartile range ,Internal medicine ,medicine ,Humans ,Inhibins ,Pharmacology (medical) ,Risk factor ,Sedentary lifestyle ,media_common ,fertility ,Gynecology ,Sertoli cell ,030219 obstetrics & reproductive medicine ,business.industry ,Health Policy ,HIV ,Middle Aged ,Confidence interval ,Cross-Sectional Studies ,Infectious Diseases ,Anti-Retroviral Agents ,Cohort ,business ,Body mass index ,Biomarkers - Abstract
ObjectivesInhibin 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. MethodsA 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. ResultsThe 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. ConclusionsGlobal 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.
- Published
- 2015