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Inconsistent results have been reported for the semen quality in HIV-infected men, due to the biases inherent in some studies. The objective of the present study was to investigate the semen parameters in HIV-1-infected patients and to compare their sperm characteristics with those of a control group of fertile, noninfected men. Factors implicated in semen alterations in HIV-1 patients were also analyzed. HIV-infected men (n=190), of whom 91% were undergoing antiretroviral therapy, and 218 fertile men were studied. Infertility risk factors were recorded and clinical examinations were performed for both groups. Records of history of HIV infection, antiretroviral treatment, and HIV-1 RNA detection in the blood as well as HIV-1 genome detection in the semen were obtained for the infected patients. Semen volumes, percentages of progressive motile spermatozoa, total sperm counts, and polymorphonuclear cell counts were decreased, while the pH values and spermatozoa multiple anomaly indices were increased in HIV-infected patients. Even after adjustment for possible sources of bias, the decreases in semen volume and progressive motility and the increase in pH remained significant. The present study demonstrates sperm motility and ejaculate volume alterations in HIV-1-infected patients, most of whom were receiving antiretroviral therapy. In HIV-1 patients, further longitudinal studies are required to analyze the impact of treatment regimen on sperm parameter alterations.

Manganese (Mn) and lead (Pb) are two neurotoxic chemicals and experimental evidence suggests that they can cross the placental barrier. Tetraethyl lead was still in use as an antiknock agent in Paris during the sampling period of the study, while it has been replaced by methylcyclopentadienyl manganese tricarbonyl (MMT) in Canada since 1977. By 1990, MMT was in 100% of gasoline in Canada. In a study of 160 pairs of mothers-neonates in Montreal and 206 pairs in Paris, we compared levels of Mn and Pb in the umbilical cord and in maternal blood. Neonates and mothers had significantly higher Pb levels in Paris where lead additives were still used in gasoline. Geometric mean maternal blood Pb levels were 5.4 microg/dl compared to 2.1 microg/dl in Montreal and cord blood Pb levels were 3.2 microg/dl in Parisian mothers compared to 1.7 microg/dl in Montreal. The prevalence of Paris Pb values superior to the 95th percentile of the Montreal distribution was highly elevated in all media studied. The prevalence of high Mn levels in umbilical cord blood was also significantly higher in Montreal. Surveillance programs are important to limit Pb overexposure and associated neurological effects in neonates where tetraethyl Pb is still in use as a gasoline additive. Since Mn is an essential element and dietary Mn intake may differ between Montreal and Paris, the difference observed with regard to high Mn values between Montreal and Paris cannot, at this time, be attributed to MMT in Montreal's gasoline. Further studies are needed to infer an association between Mn emissions from MMT and prenatal exposure to Mn.