title: Biological markers of fertility (inhibin-B) in HIV-infected men: influence of HIV infection and antiretroviral therapy.
abstract: Inhibin B (IB) levels and the IB: follicle-stimulating hormone (FSH) ratio (IFR), biomarkers of global Sertoli cell function, show a strong relationship with male fertility. The aim of the study was to examine the prevalence of impaired fertility potential in HIV-infected men and the influence of antiretroviral therapy (ART) on fertility biomarkers.
  
  
  
  A cross-sectional study with sequential sampling was carried out. A total of 169 clinically stable patients in a cohort of HIV-infected men undergoing regular ambulatory assessment in a tertiary hospital were included. The mean [± standard deviation (SD)] age of the patients was 42.6 ± 8.1 years, all were clinically stable, 61.5% had disease classified as Centers for Disease Control and Prevention (CDC) stage A, and were na?ve to ART or had not had any changes to ART for 6 months (91.1%). Morning baseline IB and FSH concentrations were measured using an enzyme-linked immunosorbent assay (ELISA) and an electrochemiluminescent immunoassay (ECLIA), respectively. A multivariate logistic regression model was used to identify factors associated with impaired fertility, defined as IB < 119 pg/mL or IFR < 23.5.
  
  
  
  The mean (± SD) IB level was 250 ± 103 pg/mL, the median [interquartile range (IQR)] FSH concentration was 5.1 (3.3-7.8) UI/L and the median (IQR) IFR was 46.1 (26.3-83.7). The prevalence of impaired fertility was 21.9% [95% confidence interval (CI) 16.3-20.7%]. Negative correlations of body mass index and waist: hip ratio with FSH and IB levels were observed (P < 0.01), while a sedentary lifestyle and previous nevirapine exposure were associated with a decreased risk of IB levels ≤ 25th percentile in multivariate analysis. Only older age, as a risk factor, and sedentary lifestyle, with a protective effect, were independently associated with impaired fertility in multivariate analysis.
  
  
  
  Global testicular Sertoli cell function and fertility potential, assessed indirectly through serum IB levels and IB: FSH ratio, appear to be well maintained in HIV-infected men and not damaged by ART.
authors.affiliation: Endocrinology and Nutrition Department, Alicante University General Hospital, Alicante, Spain.|Miguel Hernández University, San Juan de Alicante, Alicante, Spain.
authors.forename: O
authors.initials: O
authors.lastname: Moreno-Pérez
authors.affiliation: Miguel Hernández University, San Juan de Alicante, Alicante, Spain.|Infectious Diseases Unit, Alicante University General Hospital, Alicante, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Boix
authors.affiliation: Miguel Hernández University, San Juan de Alicante, Alicante, Spain.|Infectious Diseases Unit, Alicante University General Hospital, Alicante, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Merino
authors.affiliation: Endocrinology and Nutrition Department, Alicante University General Hospital, Alicante, Spain.|Miguel Hernández University, San Juan de Alicante, Alicante, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Picó
authors.affiliation: Miguel Hernández University, San Juan de Alicante, Alicante, Spain.|Infectious Diseases Unit, Alicante University General Hospital, Alicante, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Reus
authors.affiliation: Hormone Laboratory, Alicante University General Hospital, Alicante, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Alfayate
authors.affiliation: Infectious Diseases Unit, Alicante University General Hospital, Alicante, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Giner
authors.affiliation: Endocrinology and Nutrition Department, Alicante University General Hospital, Alicante, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Mirete
authors.affiliation: Preventive Medicine Department, Alicante University General Hospital, Alicante, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Sánchez-Payá
authors.affiliation: Miguel Hernández University, San Juan de Alicante, Alicante, Spain.|Infectious Diseases Unit, Alicante University General Hospital, Alicante, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Portilla
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood*; D003430:Cross-Sectional Studies; D005298:Fertility; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D007265:Inhibins / Q000097:blood*; D008297:Male; D008875:Middle Aged
chemical_list: D044966:Anti-Retroviral Agents; D015415:Biomarkers; C422364:inhibin B; D007265:Inhibins
keywords: HIV; Sertoli cell; antiretroviral treatment; fertility; inhibin-B