IMPACT OF HIV ON FERTILITY IN NAÏVE PREMENOPAUSAL FEMALES
Abstract
This study investigates the fertility status of naïve HIV-infected females of childbearing age. Approved by the Medical Ethical Committee of the University of Nigeria Teaching Hospital (UNTH), Enugu, and with informed consent obtained from all participants, the study involved 80 HIV-positive females aged 20 to 35 years from the PEPFAR HIV clinic at UNTH, Enugu. A control group of 80 age-matched, HIV-negative females was also included. Blood samples were collected and analyzed using standard methods. HIV diagnosis was confirmed through the WHO HIV test algorithm. Flow cytometry was utilized for CD4+ T lymphocyte enumeration, while hormone levels were assessed using competitive ELISA. Results indicated that serum oestradiol and progesterone levels in HIV-positive patients were significantly lower (p < 0.001) compared to the control group. However, in patients with CD4 counts ≥ 500 cells/µl, hormone levels did not significantly differ from controls (p > 0.05). Additionally, the CD4 count in HIV-positive patients was significantly reduced compared to the control group (p < 0.001). Intra-batch variations for oestradiol and progesterone were 0.53% and 1.30%, respectively, while inter-batch variations were 1.40% and 6.8%. These findings suggest that while HIV infection is associated with lower hormone levels, high CD4 counts may mitigate some effects on fertility
Keywords:
Fertility, HIV/AIDS, Oestradiol, Progesterone, CD4 T LymphocytesDownloads
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Copyright (c) 2024 Chukwuemeka Samuel Okezie , Oluchi Mary Aniebonam

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References
Almeida M, Laurent MR, Dubois V, Claessens F, O'Brien CA, Bouillon R, Vanderschueren D, Manolagas SC. Estrogens and androgens in skeletal physiology and pathophysiology. Physiological reviews 97(1):135-187.
Beyrer C, Baral SD, Griensven FV, Goodreu SM, Chariyalertsak S, Wirtz AL, Bookmeyer R (2012). Global epidemiology of HIV infection in men who have sex with men. Lancet 380(9839):367-377
Coomarasamy A, Devall AJ, Cheed V, Harb H (2019). A randomized trial of progesterone in women with bleeding in early pregnancy. The New England Journal of Medicine 380:1825-1824
Cu-Uvin S, Wright DJ, Anderson D, Kovacs A, Watts DH, Cohn J, Landay A, Reichelderfer PS (2000). Hormonal levels among HIV-1 seropositve women compared with high-risk HIV-seronegative women during the menstrual cycle. Women Health Study (WHS) 001 and WHS 001a study Team. Journal of Women Health and Gender Based Medicine 9(8):857-863.
Daar ES, Corado K (2016). Condomless sex with viriologically suppressed HIV-infected individuals: how safe is it? Journal of American Medical Association 316:171-181.
Diep CH, Daniel AR, Knutson TP, Lange CA (2015). Progesterone action in breast, uterine and ovarian cancers. Journal of Molecular Endocrinology 54(2):31-53.
Dutta D, Sharmar LK, Sharma N, Gadpayle AK, Anand A, Gaurav K, Gupta A, Poondla Y, Kulshreshtha B (2017). Occurrence, patterns and predictors of hypogonadism in patients with HIV infection in India. Indian Journal of Medical Research 145(6):804-814. Ewings AA, Ford D, Walker AS, Carpenter J, Copas A (2014). Optimal CD4+ count for initiating HIV treatment. Epidemiology 25(2):19-202.
Farsimadan M, Motamedifar M (2020). The effect of human immunodeficiency virus, human papiliomavirus, herpes simplex virus- 1 and -2, human herpes virus-6 and -8, cytomegalovirus and hepatitis B and C on female fertility and pregnancy. British Journal of Biomedical Science pp. 1-11. https://doi.org/10.1080/09674845.2020.1803540.
Finnerty F, Walker-Bone K, Tariq S (2017). Osteoporosis in post- menopausal women living with HIV. Maturitas 95:50-54.
Greenblat RM, Ameli N, Grant RM, Bacchetti P, Taylor RN (2000). Impact of the ovulatory cycle on virologic and immunologic markers in HIV-infected women. Journal of Infectious Diseases 181(1):82-90.
Haymond S, Gronowski AM (2006). Reproductive related disorders. In: Tietz text book of clinical chemistry and molecular diagnosis. 4th Edition. Butis CA, Ashwood ER, Bruns DE (Eds). Elsevier Inc. Philadelphia pp. 2097-2843.
Houshang R, Leila E, Mohammad RHM, Rosita V, Mehdi N, Mohammad RS, Ali MH, Hivasharebiani SA, Rahim R (2015). Evaluation of non-viral surrogate markers as predictive indicators for monitoring progression of HIV infection, Eight-year analysis in a regional center. Japanese Journal of Infectious Diseases DOI:10.7883/yoken.JJID.2014.261
Kosak SC, Shanks L, Beelaert G, Benson T, Savane A, Nganga A, Bita A, Zahinda JBN, Fransen K, Page A (2017). Designing HIV testing algorithms based on 2015 WHO guidelines using data from six sites in sub-saharan Africa. Journal of Clinical Microbiology 55(10):30063015.
Mirza FS, Luthra P, Chirch L (2018). Endocrinological aspect of HIV infection. Journal of Endocrinological Investigation 41(8):88-899.
Mutinta G (2014). Multiple sexual partnerships and their underlying risk influences at the University of Kwazulu Natal. Journal of Human Ecology 46(2):147-155.
Njuguna AN, Juma KK, Waihenya RK, Mpoke S, Mbuchi M, Muthami L, Mathaai R, Otieno P, Nyakundi P (2016). CD38 as surrogate marker for HIV infection in antiretroviral naive and antiretroviral experienced patients in Kenya. Advances in Molecular Diagnostics 1:107.
Okman-Kilic T (2015). Estrogen deficiency and osteoporosis. In Advances in Osteoporosis. IntechOpen. DOI: 10.5772/59407
Okoye AA, Picker LJ (2013). CD 4+ T‐cell depletion in HIV infection: mechanisms of immunological failure. Immunological reviews 254(1):54-64.
Okoye AA, Picker LJ (2013). CD4+ T cell depletion in HIV infection: androgens in skeletal physiology and pathophysiology. Physiological Reviews 19(1):135-187.
Qi J, ZhANG d, Fu X, Li C, Meng S, Dai M, Liu H, Sun J (2015). High risk of HIV transmission for men who have sex with men (MSM)-A comparison of risk factors of HIV infection among MSM associated with recruitment channels in 15 cities of China. PloS One 10(4):e0121267 doi:10:1371/journal.pone.0121267.
Ranke MB (2013). Treatment of children and adolescents with idiopathic short stature. Nature Reviews Endocrinology 9:325-334.
Selik RM, Mokotof ED, Branson B Owen SM, Whitemore S, Hall HI (2014). Revised surveillance case definition for HIV infection-United States. Morbidity and Mortality Weekly Reports 63(3):1-10.
Shete A, Dhayarkar S, Dhamanage A, Kulkarni S, Ghate M, Sangle S, Medhe U, Verma V, Rajan S, Hattori T, Gangakhedkar R (2020). Possible role of plasma Galectin-9 levels as a surrogate marker of viremia in HIV infected patients on antiretroviral therapy in resourcelimited settings. AIDS Research and Therapy 17:1-9.
Shi S, Zheng S, Li XF, Liu ZD (2017). The effect of oestradiol on growth chondrocytes of limb and spine from postnatal mice invitro: The role of oestrogen-receptor and oestradiol concentration. International Journal of Biological Sciences 13(1):100-109.
Taraborrelli S (2015). Physiology production and action of progesterone. Acta Obstetricia et Gynecologica Scandinavica 161(94):8-16.
Tüzüner U, Gülcen BS, Özdemir M (2016). Laboratory algorithm in HIV infection diagnosis. Journal of HIV for Clinical and Scientific Research 3(1):7-10.
Zubeldia-Brenner L, Roselli CE, Recabarren SE, Deniselle MCG, Lara HE (2016). Developmental and functional effects of steroid hormones on the neuroendocrine axis and spinal cord. Journal of Neuroendocrinology 27(7).