Highly active antiretroviral therapy (HAART) and testicular morphology: current status and a case for a stereologic approach.
As antiretroviral therapy becomes increasingly accessible, the associated  improvements in the health, quality of life, and survival of patients are  anticipated to influence the fertility determinants of patients, specifically  young males, within the reproductive axis. Therefore, the understanding of  testicular histology in patients with HIV/AIDS undergoing therapeutic  management is essential, because the sexual route is one of the main means of  transmission of HIV, which is localized primarily in the germ cells of the  testes. It is also important to determine whether any changes have occurred in  the testicular histologic patterns in the course of the HIV/AIDS therapy. This  review highlights the views of experts that current therapy and prolongation  of survival in HIV/AIDS patients are associated with a shift in the histologic  findings of testes toward a more pronounced loss of germ cells. There have  been attempts to use stereologic size and number estimators to quantify the  volume or number of biologically significant reference spaces and objects from  their appearance on two-dimensional sections without introducing bias from  inappropriate assumptions, models, or correction formulas. Therefore,  morphologic changes related to altered distribution of highly active  retroviral therapy within the testis and the consequent endocrine  perturbations characteristic of a potential complication of antiretroviral  treatment regimens can be analyzed in stereologic dimensions.
Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa. azu@ukzn.ac.za
Onyemaechi O
OO
Azu
D000293:Adolescent; D000328:Adult; D000353:Africa, Southern / Q000453:epidemiology; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D001814:Blood-Testis Barrier / Q000187:drug effects; D005854:Germ Cells / Q000187:drug effects / Q000473:pathology; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013737:Testis / Q000166:cytology / Q000187:drug effects*