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

Objective: To evaluate semen parameters during the natural course of asymptomatic human immunodeficiency virus-1 (HIV-1) infection. Design: A longitudinal cohort study. Setting: HIV 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 anti-retroviral 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/mm(3), and the mean blood plasma HIV-1 RNA concentration showed a statistically significant increase from 4.1 to 4.3 log(10) 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 anti-retroviral therapy on semen quality.