Semen quality remains stable during 96 weeks of untreated human immunodeficiency virus-1 infection

ObjectiveTo evaluate semen parameters during the natural course of asymptomatic human immunodeficiency virus-1 (HIV-1) infection.DesignA longitudinal cohort study.SettingHIV outpatient clinic of the Academic Medical Center in Amsterdam, the Netherlands.Patient(s)55 men infected with HIV-1, with infection of variable duration but without previous or current antiretroviral therapy.Intervention(s)Biannual blood and semen analyses.Main Outcome Measure(s)We examined the changes in semen parameters over time using a repeated measurements mixed-effects model.Result(s)The mean follow-up period was 77 weeks (interquartile range: 39 to 111 weeks). The mean CD4 cell count showed a statistically significant decline from 480 to 400 cells/mm3, and the mean blood plasma HIV-1 RNA concentration showed a statistically significant increase from 4.1 to 4.3 log10 copies/mL. None of the semen parameters showed any statistically significant change over time.Conclusion(s)Prolonged exposure to asymptomatic, untreated HIV-1 infection does not affect semen quality. These findings should be reassuring for untreated men infected with HIV-1 who wish to father a child, and they also provide relevant background information for studies investigating the potential effect of antiretroviral therapy on semen quality.