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Akhigbe RE, Akhigbe TM, Oyedokun PA, Famurewa AC. Molecular mechanisms underpinning the protection against antiretroviral drug-induced sperm-endocrine aberrations and testicular toxicity: A review. Reprod Toxicol 2024; 128:108629. [PMID: 38825169 DOI: 10.1016/j.reprotox.2024.108629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 05/27/2024] [Accepted: 05/30/2024] [Indexed: 06/04/2024]
Abstract
The introduction of highly active antiretroviral therapy (HAART) has revolutionized the treatment of HIV/AIDS worldwide. The HAART approach is the combination of two or more antiretroviral drugs of different classes and are responsible for patient's survival and declining death rates from HIV/AIDS and AIDS-related events. However, the severe and persistent reproductive side effect toxicity of HAART regimens is of great concern to patients within the reproductive age. Till date, the underlying pathophysiology of the HAART-induced reproductive toxicity remains unraveled. Nevertheless, preclinical studies show that oxidative stress and inflammation may be involved in HAART-induced sperm-endocrine deficit and reproductive aberrations. Studies are emerging demonstrating the efficacy of plant-based and non-plant products against the molecular alterations and testicular toxicity of HAART. The testicular mechanisms of mitigation by these products are associated with enhancement of testicular steroidogenesis, spermatogenesis, inhibition of oxidative stress and inflammation. This review presents the toxic effects of HAART on spermatogenesis, reproductive hormones and testis integrity. It also provides insights on the molecular mechanisms underlying the mitigation of HAART testicular toxicity by plant-based and non-plant agents. However, effect of repurposing clinical drugs to combat HAART toxicity is unknown, and more mechanistic studies are evidently needed. Altogether, plant-based and non-plant products are potential agents for prevention of rampant endocrine dysfunction and testicular toxicity of HAART.
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Affiliation(s)
- Roland E Akhigbe
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria; Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria
| | - Tunmise M Akhigbe
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria; Breeding and Genetics Unit, Department of Agronomy, Osun State University, Ejigbo Campus, Osun State, Nigeria
| | - Precious A Oyedokun
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria; Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria
| | - Ademola C Famurewa
- Department of Medical Biochemistry, Faculty of Basic Medical Sciences, College of Medical Sciences, Alex Ekwueme Federal University, Ndufu-Alike Ikwo, Ebonyi State, Nigeria.
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Ohihoin AG, Ohihoin EN, Ujomu I, Bakare A, Olanrewaju O, Okafor A, Ojetunde M, Ayoola JB, Aina O, Ajibaye O, Taylor-Robinson SD. Contemporary Anti-Retroviral Drugs (ARVDs) Disrupt Follicular Development in Female Wistar Rats. J Exp Pharmacol 2023; 15:267-278. [PMID: 37425074 PMCID: PMC10328220 DOI: 10.2147/jep.s398343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 06/22/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction There are genuine concerns that long-term use of anti-retroviral drugs may be associated with reproductive complications in females. This study aimed to ascertain the effect of highly active anti-retroviral drugs on the ovarian reserve and reproductive potential of female Wistar rats and by extension to HIV-positive human females. Methods A total of 25 female Wistar rats, weighing between 140g and 162g, were randomly allotted into non-intervention and intervention groups, receiving the anti-retroviral drugs, Efavirenz (EFV), Tenofovir Disoproxil Fumarate (TDF), Lamivudine (3TC), and a fixed-dose combination (FDC). The dosage was administered orally at 8 am daily for 4 weeks. Serum concentrations of anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinising hormone (LH), and estradiol were measured using standard biochemical techniques (ELISA). Follicular counts were made on fixed ovarian tissue from the sacrificed rats. Results The mean AMH level for the control group and the EFV, TDF, 3TC, and FDC groups were 11.20, 6.75, 7.30, 8.27, and 6.60 pmol/L, respectively. The EFV and FDC groups had the lowest AMH, compared to the other groups, but there was no statistically significant difference in AMH across the groups. The mean count of antral follicles was significantly lower in the group that received EFV when compared to the other groups. The corpus luteal count was significantly higher in the control group than in the intervention groups. Conclusion The study demonstrated a disruption in the reproductive hormones of female Wistar rats receiving anti-retroviral regimens containing EFV. Clinical studies are required to determine if these changes are seen in women receiving EFV-based treatment, as this may compromise reproductive function and predispose them to early menopause.
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Affiliation(s)
- Aigbe Gregory Ohihoin
- Clinical Sciences Department, Nigerian Institute of Medical Research (NIMR), Lagos, Nigeria
| | | | - Ifeoma Ujomu
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Airat Bakare
- College of Medicine, University of Lagos, Lagos, Nigeria
| | | | - Arinze Okafor
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Mercy Ojetunde
- Clinical Sciences Department, Nigerian Institute of Medical Research (NIMR), Lagos, Nigeria
| | - Joy Boluwatife Ayoola
- Central Research Laboratory, Nigerian Institute of Medical Research (NIMR), Lagos, Nigeria
| | - Oluwagbemiga Aina
- Biochemistry and Nutrition Department, Nigerian Institute of Medical Research (NIMR), Lagos, Nigeria
| | - Olusola Ajibaye
- Biochemistry and Nutrition Department, Nigerian Institute of Medical Research (NIMR), Lagos, Nigeria
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Nibamureke UMC, Wagenaar GM. Histopathological changes in Oreochromis mossambicus (Peters, 1852) ovaries after a chronic exposure to a mixture of the HIV drug nevirapine and the antibiotics sulfamethoxazole and trimethoprim. CHEMOSPHERE 2021; 274:129900. [PMID: 33979944 PMCID: PMC8049986 DOI: 10.1016/j.chemosphere.2021.129900] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/16/2021] [Accepted: 02/03/2021] [Indexed: 05/14/2023]
Abstract
The burden of the human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) infection has transformed the African continent into a major consumer of antiretrovirals (ARVs) drugs. In addition to HIV burden, the African continent has also a high incidence of tuberculosis (TB) and has been experiencing recurring outbreaks of several other viral, bacterial, and parasitic epidemic diseases. The novel severe acute respiratory syndrome coronavirus 2 (SARS-COV-2 or Covid-19) pandemic outbreak is adding to the continent's infectious diseases burden as experts are predicting that it will be here for a long time. One of the consequences of these infectious diseases is that antiviral and antibiotic compounds have become some of the most consumed pharmaceuticals on the continent. Many of these drugs have been frequently detected in surface waters across Africa. There is limited information available on the adverse effects of the mixtures of different types of pharmaceuticals in African aquatic environments on fish reproduction. The present study investigated the effects of the ARV drug nevirapine (NVP - 1.48 and 3.74 μg/L) and its mixture with the antibiotic sulfamethoxazole (3.68 μg/L) and trimethoprim (0.87 μg/L) on O. mossambicus gonads using histopathological endpoints as biomarkers. The fish (n = 52) were exposed for 30 days in a static renewal system. Female O. mossambicus exposed to nevirapine (3.74 μg/L) and to NVP - antibiotic mixture recorded higher ovary indices. Statistically significant differences were found in female ovary indices between the fish exposed to NVP (3.74 μg/L) and the control fish (p = 0.002) as well as between the fish exposed to the NVP - antibiotic mixture and the control fish (p = 0.009). The main observed histopathological changes in the ovaries were increased vitellogenic oocyte atresia and vacuolation of the interstitial tissue in the fish exposed to NVP - antibiotic mixture. It is evident that the presence of NVP - antibiotics mixture in water triggered the observed histopathology in female fish ovaries. The detected abnormal high rate of atretic oocytes could result in impaired fish reproduction.
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Affiliation(s)
- U M C Nibamureke
- Department of Zoology, PO Box 524, Auckland Park, University of Johannesburg, 2006, South Africa.
| | - G M Wagenaar
- Department of Zoology, PO Box 524, Auckland Park, University of Johannesburg, 2006, South Africa.
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Shallie PD, Naicker T. Differential upregulations of SMAC and LAMIN B levels in the buffy coat of HIV associated preeclamptic women. J Matern Fetal Neonatal Med 2021; 35:5080-5086. [PMID: 33478301 DOI: 10.1080/14767058.2021.1875210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To assess HIV positivity as an apoptotic confounding variable in pregnancies complicated by preeclampsia. METHODS AND MATERIALS Using a Bio-plex Multiplex Immunoassay, Smac and Lamin B concentrations (ng/ml) were analyzed in a buffy coat collected from 128 pregnant women attending a large regional hospital in Durban, South Africa. Study groups consisted of Normotensive and Preeclamptic pregnant women stratified according to their HIV status. All HIV positive groups received highly active antiretroviral therapy (HAART). RESULTS Our findings showed significant (p < .05) upregulation in the levels of both SMAC and LAMIN B in the HIV positive patients and a concomitant downregulation of the same apoptotic makers were observed in preeclampsia regardless of HIV status. CONCLUSIONS These results could be associated with the fact that apoptosis promotes deregulation of mitochondrial dynamics, contributing to the associated severe obstetric events observed in pregnancies among HIV-infected women on HAART.
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Affiliation(s)
- Philemon D Shallie
- Optics and Imaging Centre, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.,Anatomy, College of Medicine, Olabisi Onabanjo University, Sagamu, Nigeria
| | - Thajasvarie Naicker
- Optics and Imaging Centre, College of Health Sciences, Doris Duke Medical Research Institute, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
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Ninive C, Ferraretto X, Gricourt S, Llabador MA, Lepage J, Gauché-Cazalis C, Epelboin S, Peigné M. [Assisted reproductive technologies in HIV patients: Which results and which strategy in France in 2019?]. ACTA ACUST UNITED AC 2019; 47:362-369. [PMID: 30753900 DOI: 10.1016/j.gofs.2019.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Indexed: 01/22/2023]
Abstract
With the use of antiretroviral therapy, HIV transmission from mother to fetus and between sexual partners has been significantly reduced, successively allowing pregnancy, then assisted reproductive technologies, and targeted unprotected sex among couples living with HIV. Since first French Morlat report in 2013, natural procreation is now possible under certain conditions for these couples living with HIV and the use of assisted reproductive technologies is increasingly limited to the treatment of infertility. While the results of intrauterine insemination seem satisfactory for serodiscordant couples living with HIV, in vitro fertilization results appear to be unfavorable when the woman is infected with HIV. In vitro fertilization results appear to be comparable to those in general population when only the man is infected with HIV. It can be assumed that ovaries are impacted by the treatment and/or the HIV in infected women.
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Affiliation(s)
- C Ninive
- Unité de médecine de la reproduction, service de gynécologie-obstétrique, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France
| | - X Ferraretto
- Service de biologie de la reproduction, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France
| | - S Gricourt
- Unité de médecine de la reproduction, service de gynécologie-obstétrique, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France
| | - M A Llabador
- Service de biologie de la reproduction, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France
| | - J Lepage
- Unité de médecine de la reproduction, service de gynécologie-obstétrique, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France
| | - C Gauché-Cazalis
- Unité de médecine de la reproduction, service de gynécologie-obstétrique, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France
| | - S Epelboin
- Unité de médecine de la reproduction, service de gynécologie-obstétrique, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France
| | - M Peigné
- Unité de médecine de la reproduction, service de gynécologie-obstétrique, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France.
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Nucleoside reverse transcriptase inhibitor-induced rat oocyte dysfunction and low fertility mediated by autophagy. Oncotarget 2017; 9:3895-3907. [PMID: 29423092 PMCID: PMC5790509 DOI: 10.18632/oncotarget.23243] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 12/01/2017] [Indexed: 12/16/2022] Open
Abstract
Low fertility is one of the most common side effects caused by nucleoside reverse transcriptase inhibitors (NRTIs), whereas the molecular mechanism underlying this process were largely unclear. This study was conducted to investigate whether autophagy plays a role in NRTIs-induced oocyte dysfunction and low fertility in female rat. Both in vivo and in vitro experiments were conducted. For the in vivo experiment, female adult Sprague-Dawley rats were subjected to zidovudine (AZT) and lamivudine (3TC) intragastric treatment for 3, 6, 9, and 12 weeks; a control was also set. Oocytes were collected for maturation evaluation, in vitro fertilization and mitochondrial function assays, and apoptosis and autophagy analysis. For the in vitro experiment, oocytes were collected and assigned to the control, 3-methyladenine (3-MA, an effective autophagy inhibitor), AZT, AZT+3-MA, 3TC, and 3TC+3-MA groups. The oocytes were cultured with the abovementioned drugs for 24, 48, and 72 h and then, subjected to the same assays as in the in vivo study. The results showed a significant time-dependent decrease in oocyte maturation-related maker levels, oocyte cleavage rate, blastocyst formation rate, mitochondrial DNA copy number and adenosine triphosphate level, and apoptosis, and a significant increase in the reactive oxygen species levels (all P-values < 0.05), in both the in vivo and the in vitro experiments. These changes, except for the changes in the oocyte maturation-related markers, were partially attenuated by 3-MA. In conclusion, we demonstrated that NRTIs can cause rat oocyte dysfunction and low fertility, and this damage was, at least partially, mediated by autophagy.
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Mataró D, García D, Coll O, Vassena R, Rodríguez A. Lower endometrial receptivity in HIV-infected women receiving oocyte donation: a comorbidity of HIV infection? Hum Reprod Open 2017; 2017:hox019. [PMID: 30895233 PMCID: PMC6276669 DOI: 10.1093/hropen/hox019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 08/22/2017] [Accepted: 10/07/2017] [Indexed: 01/13/2023] Open
Abstract
STUDY QUESTION Are the reproductive outcomes of HIV-infected donor oocyte recipient women comparable to those of non-infected women? SUMMARY ANSWER HIV-infected women have lower clinical pregnancy and live birth rates than non-infected women. WHAT IS ALREADY KNOWN The literature on the effect of HIV infection on reproductive outcome is scarce at best; the only report to date comparing oocyte donation cycles in HIV-infected women versus non-infected controls found no differences in pregnancy rates between the two groups. However, this study was performed nearly a decade ago and did not evaluate the effect of immuno-virological characteristics of oocyte recipients or the HIV antiretroviral therapy effect. STUDY DESIGN SIZE, AND DURATION This is a matched-cohort study including 514 oocyte donation cycles, 257 from HIV-infected women and 257 non-infected controls, performed between April 2004 and November 2014. PARTICIPANTS/MATERIALS, SETTING, AND METHOD Each cycle of an HIV-infected woman (n = 257) was matched with a cycle of a non-infected woman (1:1). Biochemical pregnancy, clinical pregnancy, ongoing pregnancy and live birth in the two groups were compared using a multivariate logistic regression analysis. The effect of antiretroviral treatment options on pregnancy outcomes of HIV-infected women was analyzed using a logistic regression model adjusted for time elapsed from diagnosis, and CD4 levels and viral load prior to embryo transfer. MAIN RESULTS AND THE ROLE OF CHANCE Cycles of HIV-infected patients receiving oocyte donation presented lower pregnancy and live birth rates than matched non-infected controls. Treatment options and infection parameters analyzed do not seem to affect the reproductive results in HIV-infected women. The variable most influencing pregnancy outcomes was the number of transferred embryos; lower pregnancy rates were obtained after single embryo transfer. LIMITATIONS REASONS FOR CAUTION Patients with HIV infection have specific health issues, such as infection/treatment side effects, which makes it impossible to find a matching control group of non-infected patients for these variables. WIDER IMPLICATIONS OF THE FINDINGS HIV-infected women receiving donated oocytes present lower pregnancy rates when compared to non-infected controls, regardless of the antiretroviral treatment followed. The complexity of the treatments (both in medication types and combinations) makes it difficult to define whether any one treatment option is better than the others in terms of pregnancy outcomes in oocyte recipients. STUDY FUNDING/COMPETING INTERESTS None. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- Daniel Mataró
- Clínica EUGIN, Travessera de Les Corts 322, Barcelona 08029, Spain
| | - Désirée García
- Fundació Privada EUGIN, Travessera de Les Corts 314, Barcelona 08029, Spain
| | - Oriol Coll
- Clínica EUGIN, Travessera de Les Corts 322, Barcelona 08029, Spain
| | - Rita Vassena
- Clínica EUGIN, Travessera de Les Corts 322, Barcelona 08029, Spain
| | - Amelia Rodríguez
- Clínica EUGIN, Travessera de Les Corts 322, Barcelona 08029, Spain
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Hernandez S, Moren C, Catalán‐García M, Lopez M, Guitart‐Mampel M, Coll O, Garcia L, Milisenda J, Justamante A, Gatell JM, Cardellach F, Gratacos E, Miro Ò, Garrabou G. Mitochondrial toxicity and caspase activation in HIV pregnant women. J Cell Mol Med 2017; 21:26-34. [PMID: 27577111 PMCID: PMC5192803 DOI: 10.1111/jcmm.12935] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 06/12/2016] [Indexed: 12/19/2022] Open
Abstract
To assess the impact of HIV-infection and highly active anti-retroviral treatment in mitochondria and apoptotic activation of caspases during pregnancy and their association with adverse perinatal outcome. Changes of mitochondrial parameters and apoptotic caspase activation in maternal peripheral blood mononuclear cells were compared at first trimester of pregnancy and delivery in 27 HIV-infected and -treated pregnant women versus 24 uninfected pregnant controls. We correlated immunovirological, therapeutic and perinatal outcome with experimental findings: mitochondrial DNA (mtDNA) content, mitochondrial protein synthesis, mitochondrial function and apoptotic caspase activation. The HIV pregnancies showed increased adverse perinatal outcome (OR: 4.81 [1.14-20.16]; P < 0.05) and decreased mtDNA content (42.66 ± 5.94%, P < 0.01) compared to controls, even higher in naïve participants. This depletion caused a correlated decrease in mitochondrial protein synthesis (12.82 ± 5.73%, P < 0.01) and function (20.50 ± 10.14%, P < 0.001), not observed in controls. Along pregnancy, apoptotic caspase-3 activation increased 63.64 ± 45.45% in controls (P < 0.001) and 100.00 ± 47.37% in HIV-pregnancies (P < 0.001), in correlation with longer exposure to nucleoside analogues. HIV-infected women showed increased obstetric problems and declined genetic and functional mitochondrial parameters during pregnancy, especially those firstly exposed to anti-retrovirals. The apoptotic activation of caspases along pregnancy is emphasized in HIV pregnancies promoted by nucleoside analogues. However, we could not demonstrate direct mitochondrial or apoptotic implication in adverse obstetric outcome probably because of the reduced sample size.
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Affiliation(s)
- Sandra Hernandez
- Maternal‐Fetal Medicine DepartmentClinical Institute of Gynecology, Obstetrics and NeonatologyHospital Clinic of BarcelonaBarcelonaSpain
- Muscle Research and Mitochondrial Function LaboratoryCellex‐IDIBAPSFaculty of Medicine‐University of BarcelonaHospital Clinic of BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)MadridSpain
| | - Constanza Moren
- Muscle Research and Mitochondrial Function LaboratoryCellex‐IDIBAPSFaculty of Medicine‐University of BarcelonaHospital Clinic of BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)MadridSpain
| | - Marc Catalán‐García
- Muscle Research and Mitochondrial Function LaboratoryCellex‐IDIBAPSFaculty of Medicine‐University of BarcelonaHospital Clinic of BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)MadridSpain
| | - Marta Lopez
- Maternal‐Fetal Medicine DepartmentClinical Institute of Gynecology, Obstetrics and NeonatologyHospital Clinic of BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)MadridSpain
| | - Mariona Guitart‐Mampel
- Muscle Research and Mitochondrial Function LaboratoryCellex‐IDIBAPSFaculty of Medicine‐University of BarcelonaHospital Clinic of BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)MadridSpain
| | | | - Laura Garcia
- Maternal‐Fetal Medicine DepartmentClinical Institute of Gynecology, Obstetrics and NeonatologyHospital Clinic of BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)MadridSpain
| | - Jose Milisenda
- Muscle Research and Mitochondrial Function LaboratoryCellex‐IDIBAPSFaculty of Medicine‐University of BarcelonaHospital Clinic of BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)MadridSpain
| | - Angela Justamante
- Muscle Research and Mitochondrial Function LaboratoryCellex‐IDIBAPSFaculty of Medicine‐University of BarcelonaHospital Clinic of BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)MadridSpain
| | | | - Francesc Cardellach
- Muscle Research and Mitochondrial Function LaboratoryCellex‐IDIBAPSFaculty of Medicine‐University of BarcelonaHospital Clinic of BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)MadridSpain
| | - Eduard Gratacos
- Maternal‐Fetal Medicine DepartmentClinical Institute of Gynecology, Obstetrics and NeonatologyHospital Clinic of BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)MadridSpain
| | - Òscar Miro
- Muscle Research and Mitochondrial Function LaboratoryCellex‐IDIBAPSFaculty of Medicine‐University of BarcelonaHospital Clinic of BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)MadridSpain
| | - Gloria Garrabou
- Muscle Research and Mitochondrial Function LaboratoryCellex‐IDIBAPSFaculty of Medicine‐University of BarcelonaHospital Clinic of BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)MadridSpain
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Bujan L, Pasquier C. People living with HIV and procreation: 30 years of progress from prohibition to freedom? Hum Reprod 2016; 31:918-25. [PMID: 26975324 DOI: 10.1093/humrep/dew036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 02/07/2016] [Indexed: 01/26/2023] Open
Abstract
The emergence of human immunodeficiency virus (HIV) infection in the 1980s drastically changed the prospects of conceiving a child for the man or woman infected with the virus. Advances in treatment then made it possible to envisage pregnancy while decreasing the risk of transmission to the child when the mother was infected. For couples where one partner was HIV-positive and who desired a child, recourse to medical help, notably medically assisted procreation, was discouraged, and very few centres offered such assistance in the 1980s and 1990s. Improved knowledge of viral excretion in the genital tracts, together with more effective treatment, made it possible to envisage medically assisted procreation for these couples, allowing them to have a child while at the same time likely reducing the risk of transmitting HIV to their partner. Several programmes have demonstrated their effectiveness in this domain. Owing to continually increasing knowledge over the past decade, natural conception can now be proposed. Couples where one or both partners are HIV-positive may opt for medically assisted procreation or natural reproduction. Specialists in reproductive medicine and HIV specialists need to provide couples with objective information allowing them to achieve near-optimal conditions that minimize HIV transmission risk. Couples will then be able to choose freely the mode of procreation most appropriate for them.
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Affiliation(s)
- L Bujan
- Université Toulouse-III Paul Sabatier, Groupe de Recherche en Fertilité Humaine (EA 3694, Human Fertility Research Group), Toulouse, France CECOS, Centre Hospitalier Universitaire Paule de Viguier, Toulouse, France
| | - C Pasquier
- INSERM U1043, CPTP, Centre Hospitalier Universitaire Toulouse-Purpan, BP 3028, F-31024 Toulouse, France Université Toulouse-III Paul Sabatier, CPTP, F-31024 Toulouse, France Laboratoire de Virologie, Centre Hospitalier Universitaire Toulouse-Purpan, F-31059 Toulouse, France
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10
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Stora C, Epelboin S, Devouche E, Matheron S, Epelboin L, Yazbeck C, Damond F, Longuet P, Dzineku F, Rajguru M, Delaroche L, Mandelbrot L, Luton D, Patrat C. Women infected with human immunodeficiency virus type 1 have poorer assisted reproduction outcomes: a case-control study. Fertil Steril 2016; 105:1193-1201. [PMID: 26801068 DOI: 10.1016/j.fertnstert.2015.12.138] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 12/27/2015] [Accepted: 12/31/2015] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To compare the efficacy of assisted reproductive technology (ART) in women infected with human immunodeficiency virus type 1 (HIV-1) versus HIV-negative controls. DESIGN Retrospective case-control study. SETTING University hospital ART unit. PATIENT(S) Eighty-two women infected with HIV-1 and 82 women as seronegative controls. INTERVENTION(S) Ovarian stimulation, oocytes retrieval, standard in vitro fertilization (IVF) or intracytoplasmic sperm injection, embryo transfer. MAIN OUTCOME MEASURE(S) Clinical pregnancies and live-birth rates. RESULT(S) After oocyte retrieval, all women infected with HIV-1 infected were matched 1:1 to HIV-negative controls according to the following criteria: date of ART attempt, age, parity, main cause of infertility, ART technique, and rank of attempt. Only the first IVF cycle during the study period was considered for each couple. We found no statistically significant differences between the two groups for ovarian stimulation data, fertilization rate, or average number of embryos transferred. The clinical pregnancy rate per transfer was statistically significantly lower for the cases compared with the controls (12% vs. 32%), as were the implantation rate (10% vs. 21%) and the live-birth rate (7% vs. 19%). CONCLUSION(S) In one of the largest studies to pair six factors that influence the results of ART, HIV infection in women was associated with poorer outcomes after ART. These results suggest that women with controlled HIV-1-infection should be counseled not to delay ART in cases of self-insemination failure or other causes of infertility. Fertility preservation by vitrification of oocytes in women whose pregnancy should be delayed may be an important future consideration.
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Affiliation(s)
- Camille Stora
- Department of Gynecology, Obstetrics and Reproduction, Assistance Publique-Hôpitaux de Paris, Bichat Claude Bernard Hospital, Paris, France
| | - Sylvie Epelboin
- Department of Gynecology, Obstetrics and Reproduction, Assistance Publique-Hôpitaux de Paris, Bichat Claude Bernard Hospital, Paris, France; Paris 7-Denis Diderot University, Paris, France.
| | - Emmanuel Devouche
- Laboratory of Psychopathology and Health Process, Paris-Descartes University, Paris, France
| | - Sophie Matheron
- Department of Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Bichat Claude Bernard Hospital, Paris France; Paris 7-Denis Diderot University, INSERM UMR 1137 IAME, Paris, France
| | - Loïc Epelboin
- Infectious and Tropical Diseases Unit, Andrée Rosemon Hospital, Guiana University, Pasteur Institute of Guiana (EPaT) EA 3593, Cayenne, French Guiana
| | - Chadi Yazbeck
- Department of Gynecology, Obstetrics and Reproduction, Assistance Publique-Hôpitaux de Paris, Bichat Claude Bernard Hospital, Paris, France; Paris 7-Denis Diderot University, Paris, France
| | - Florence Damond
- Department of Virology, Assistance Publique-Hôpitaux de Paris, Bichat Claude Bernard Hospital, Paris, France
| | - Pascale Longuet
- Department of Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Bichat Claude Bernard Hospital, Paris France
| | - Frederick Dzineku
- Department of Gynecology, Hôpital Maisonneuve-Rosemont, Centre Hospitalier Universitaire Affilié-Université de Montréal, Montréal, Quebec, Canada
| | - Mandovi Rajguru
- Department of Gynecology, Obstetrics and Reproduction, Assistance Publique-Hôpitaux de Paris, Bichat Claude Bernard Hospital, Paris, France
| | - Lucie Delaroche
- Department of Reproductive Biology, Assistance Publique-Hôpitaux de Paris, Bichat Claude Bernard Hospital, Paris, France
| | - Laurent Mandelbrot
- Paris 7-Denis Diderot University, Paris, France; Department of Gynecology and Obstetrics, Assistance Publique-Hôpitaux de Paris, Louis Mourier Hospital, Colombes, France
| | - Dominique Luton
- Department of Gynecology, Obstetrics and Reproduction, Assistance Publique-Hôpitaux de Paris, Bichat Claude Bernard Hospital, Paris, France; Paris 7-Denis Diderot University, Paris, France
| | - Catherine Patrat
- Paris 7-Denis Diderot University, Paris, France; Department of Reproductive Biology, Assistance Publique-Hôpitaux de Paris, Bichat Claude Bernard Hospital, Paris, France
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Lights and Shadows about the Effectiveness of IVF in HIV Infected Women: A Systematic Review. Infect Dis Obstet Gynecol 2015; 2015:517208. [PMID: 26778910 PMCID: PMC4686718 DOI: 10.1155/2015/517208] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 11/06/2015] [Accepted: 11/12/2015] [Indexed: 01/20/2023] Open
Abstract
Background. HIV infected women have higher rates of infertility. Objective. The purpose of this literature review is to evaluate the effectiveness of fresh IVF/ICSI cycles in HIV infected women. Materials and Methods. A search of the PubMed database was performed to identify studies assessing fresh nondonor oocyte IVF/ICSI cycle outcomes of serodiscordant couples with an HIV infected female partner. Results and Discussion. Ten studies met the inclusion criteria. Whenever a comparison with a control group was available, with the exception of one case, ovarian stimulation cancelation rate was higher and pregnancy rate (PR) was lower in HIV infected women. However, statistically significant differences in both rates were only seen in one and two studies, respectively. A number of noncontrolled sources of bias for IVF outcome were identified. This fact, added to the small size of samples studied and heterogeneity in study design and methodology, still hampers the performance of a meta-analysis on the issue. Conclusion. Prospective matched case-control studies are necessary for the understanding of the specific effects of HIV infection on ovarian response and ART outcome.
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Abstract
BACKGROUND Mitochondrial consequences from foetal exposure to HIV infection and antiretrovirals could be further investigated. OBJECTIVE The main objective of this study was to evaluate maternofoetal mitochondrial disturbances in HIV infection and antiretroviral administration in human pregnancies as the aetiopathogenic basis of suboptimal perinatal-clinical features. DESIGN Cross-sectional, prospective, observational, exploratory and controlled study. METHODS Clinical/epidemiological data of 35 HIV-infected pregnant women and 17 controls were collected. Mitochondrial DNA (mtDNA) and RNA (mtRNA) content (real time-PCR), enzymatic activities and content (spectrophotometry) were measured in leucocytes. Genetic-functional, maternofoetal and molecular-clinical correlations were assessed. RESULTS Birth weight was lower in infants from HIV-infected mothers compared with controls. MtDNA values were slightly decreased in HIV cases, although not reaching statistical significance. MtRNA values were lower in HIV-infected mothers. Similarly, binary complex II+III enzymatic activity decreased to 50% in both HIV-infected mothers (44.45 ± 3.77%) and their infants (48.79 ± 3.41%) (P = 0.001 and P < 0.001). Global CI+III+IV enzymatic activity was lower in HIV-infected mothers and infants (90.43 ± 2.39% and 51.16 ± 9.30%) (P < 0.005 and P < 0.05). MtDNA content correlated with function in mothers and infants. Maternofoetal parameters correlated at genetic and functional levels. CONCLUSION HAART toxicity caused mitochondrial damage in HIV-infected pregnant women and their newborns, being present at a genetic and functional level with a maternofoetal correlation.
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Morén C, Hernández S, Guitart-Mampel M, Garrabou G. Mitochondrial toxicity in human pregnancy: an update on clinical and experimental approaches in the last 10 years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:9897-918. [PMID: 25247430 PMCID: PMC4199057 DOI: 10.3390/ijerph110909897] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 09/05/2014] [Accepted: 09/17/2014] [Indexed: 01/19/2023]
Abstract
Mitochondrial toxicity can be one of the most dreadful consequences of exposure to a wide range of external agents including pathogens, therapeutic agents, abuse drugs, toxic gases and other harmful chemical substances. However, little is known about the effects of mitochondrial toxicity on pregnant women exposed to these agents that may exert transplacental activity and condition fetal remodeling. It has been hypothesized that mitochondrial toxicity may be involved in some adverse obstetric outcomes. In the present study, we investigated the association between exposure to mitochondrial toxic agents and pathologic conditions ranging from fertility defects, detrimental fetal development and impaired newborn health due to intra-uterine exposure. We have reviewed data from studies in human subjects to propose mechanisms of mitochondrial toxicity that could be associated with the symptoms present in both exposed pregnant and fetal patients. Since some therapeutic interventions or accidental exposure cannot be avoided, further research is needed to gain insight into the molecular pathways leading to mitochondrial toxicity during pregnancy. The ultimate objective of these studies should be to reduce the mitochondrial toxicity of these agents and establish biomarkers for gestational monitoring of harmful effects.
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Affiliation(s)
- Constanza Morén
- Muscle Research and Mitochondrial Function Laboratory, Cellex-IDIBAPS-Faculty of Medicine-University of Barcelona, Internal Medicine Service-Hospital Clínic of Barcelona, Barcelona 08036, Spain.
| | - Sandra Hernández
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Raras, CIBERER, Valencia 46010, Spain.
| | - Mariona Guitart-Mampel
- Muscle Research and Mitochondrial Function Laboratory, Cellex-IDIBAPS-Faculty of Medicine-University of Barcelona, Internal Medicine Service-Hospital Clínic of Barcelona, Barcelona 08036, Spain.
| | - Glòria Garrabou
- Muscle Research and Mitochondrial Function Laboratory, Cellex-IDIBAPS-Faculty of Medicine-University of Barcelona, Internal Medicine Service-Hospital Clínic of Barcelona, Barcelona 08036, Spain.
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14
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Kushnir VA, Lewis W. Human immunodeficiency virus/acquired immunodeficiency syndrome and infertility: emerging problems in the era of highly active antiretrovirals. Fertil Steril 2011; 96:546-53. [PMID: 21722892 DOI: 10.1016/j.fertnstert.2011.05.094] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Accepted: 05/31/2011] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To review the effects of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in terms of its associated comorbid conditions and the side effects of antiretroviral treatment on fertility. DESIGN PubMed computer search to identify relevant articles. SETTING Research institution. PATIENT(S) None. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) None. RESULT(S) Biological alterations in reproductive physiology may account for subfertility in patients infected with HIV. Psychosocial factors in patients with HIV infection may affect their reproductive desires and outcomes. Antiretroviral medications may have direct toxicity on gametes and embryos. Available evidence indicates that fertility treatments can be a safe option for couples with HIV-discordant infection status, although the potential risk of viral transmission cannot be completely eliminated. CONCLUSION(S) Because their potential reproductive desires are increasingly becoming a concern in the health care of young HIV-infected patients, additional data are needed to address the effect of HIV and its treatments on their fertility and reproductive outcomes.
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Affiliation(s)
- Vitaly A Kushnir
- Department of Gynecology and Obstetrics, Emory University, Atlanta, Georgia 30312, USA.
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15
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HIV-1 or hepatitis C chronic infection in serodiscordant infertile couples has no impact on infertility treatment outcome. Fertil Steril 2010; 93:1020-3. [DOI: 10.1016/j.fertnstert.2009.07.1663] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Revised: 07/04/2009] [Accepted: 07/24/2009] [Indexed: 11/20/2022]
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