Outcomes from the first assisted reproduction program for HIV-serodiscordant couples in Australia
Objective: To describe the clinical outcomes for all HIV‐serodiscordant couples attending an assisted reproduction program. Design, setting and participants: Retrospective review of demographic, clinical and outcome data for all HIV‐serodiscordant couples who attended an assisted reproduction progra...
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| Veröffentlicht in: | Medical journal of Australia 2011-11, Vol.195 (10), p.599-601 |
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| creator | Giles, Michelle L Barak, Shlomi Baker, Gordon Tabrizi, Sepehr Greengrass, Vicki Bourne, Harold Clarke, Gary N Peak, Suellen A Hoy, Jennifer F Foster, Penelope Knight, Rachael L |
| description | Objective: To describe the clinical outcomes for all HIV‐serodiscordant couples attending an assisted reproduction program.
Design, setting and participants: Retrospective review of demographic, clinical and outcome data for all HIV‐serodiscordant couples who attended an assisted reproduction program at a tertiary hospital in Melbourne, between its commencement in 2003 and June 2010.
Main outcome measures: Pregnancies, miscarriages, births, HIV transmission to the HIV‐negative partner, semen quality and detection of HIV (HIV RNA and HIV DNA) in semen.
Results: As of June 2010, 39 HIV‐positive clients had proceeded to assisted reproduction after the initial consultation in the program. There were 162 completed cycles, with 26 pregnancies (clinical pregnancy rate per cycle, 16.2% for HIV‐positive men with an HIV‐negative partner, and 15.4% for HIV‐positive women). Of all 222 tested semen samples, 18 (8%) had HIV RNA detected despite these men receiving antiretroviral therapy and having an undetectable HIV viral load in plasma. Sperm velocity was significantly lower in HIV‐positive clients receiving combination antiretroviral therapy than in a control group of recipient‐recruited sperm donors (P = 0.01); there were no other significant differences in sperm quality between the two groups. No HIV transmission to babies or HIV‐negative partners occurred.
Conclusion: Our findings show detectable HIV in 8% of semen samples from men with an undetectable HIV viral load in plasma, but confirm the safety of assisted reproduction for HIV‐serodiscordant couples within a program with strict protocols for HIV treatment and testing of all semen before use. |
| doi_str_mv | 10.5694/mja11.10156 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_905965933</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><informt_id>10.3316/ielapa.201202918</informt_id><sourcerecordid>905965933</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4229-47da51b8f3d5f1dcf57e42b043271e2af5bfc21b5fed67b430fed9c9671cb763</originalsourceid><addsrcrecordid>eNp9kU1vFDEMhkcIRJfCiTvKBXGopiTOZNIcVxX9QEW9VIhb5MlHm2pmMiQZof57st0Fbpxsy49fW6-b5j2jp6JX3efpERk7ZZSJ_kWzYRz6VnApXzYbSkG0EtSPo-ZNzo-1ZALk6-YIgFFJGd00eLsWEyeXiU9xIuXBER9SLgRzDrk4S5JbUrSrKSHOpKb3CSfiYyJX19_b7GovZBOTxbkQE9dlrFphJts1l4RjwLfNK49jdu8O8bi5u_hyd37V3txeXp9vb1rTAai2kxYFG848t8Iza7yQroOBdhwkc4BeDN4AG4R3tpdDx2lNlFG9ZGaQPT9uPu1l64k_V5eLnupdbhxxdnHNWlGheqE4r-TJnjQp5pyc10sKE6YnzajeOaqfHdXPjlb6w0F3HSZn_7J_LKzAxwOA2eDoE84m5H-cAEE5QOXonvsVRvf0v53629ctCKXqyMV-JE2haFzQF_1QypK1xYI6zPUNu05M99rGsNPinPU6uLHCGigDCoqd8d8tO6e3</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>905965933</pqid></control><display><type>article</type><title>Outcomes from the first assisted reproduction program for HIV-serodiscordant couples in Australia</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Giles, Michelle L ; Barak, Shlomi ; Baker, Gordon ; Tabrizi, Sepehr ; Greengrass, Vicki ; Bourne, Harold ; Clarke, Gary N ; Peak, Suellen A ; Hoy, Jennifer F ; Foster, Penelope ; Knight, Rachael L</creator><creatorcontrib>Giles, Michelle L ; Barak, Shlomi ; Baker, Gordon ; Tabrizi, Sepehr ; Greengrass, Vicki ; Bourne, Harold ; Clarke, Gary N ; Peak, Suellen A ; Hoy, Jennifer F ; Foster, Penelope ; Knight, Rachael L ; CVI Study Group</creatorcontrib><description>Objective: To describe the clinical outcomes for all HIV‐serodiscordant couples attending an assisted reproduction program.
Design, setting and participants: Retrospective review of demographic, clinical and outcome data for all HIV‐serodiscordant couples who attended an assisted reproduction program at a tertiary hospital in Melbourne, between its commencement in 2003 and June 2010.
Main outcome measures: Pregnancies, miscarriages, births, HIV transmission to the HIV‐negative partner, semen quality and detection of HIV (HIV RNA and HIV DNA) in semen.
Results: As of June 2010, 39 HIV‐positive clients had proceeded to assisted reproduction after the initial consultation in the program. There were 162 completed cycles, with 26 pregnancies (clinical pregnancy rate per cycle, 16.2% for HIV‐positive men with an HIV‐negative partner, and 15.4% for HIV‐positive women). Of all 222 tested semen samples, 18 (8%) had HIV RNA detected despite these men receiving antiretroviral therapy and having an undetectable HIV viral load in plasma. Sperm velocity was significantly lower in HIV‐positive clients receiving combination antiretroviral therapy than in a control group of recipient‐recruited sperm donors (P = 0.01); there were no other significant differences in sperm quality between the two groups. No HIV transmission to babies or HIV‐negative partners occurred.
Conclusion: Our findings show detectable HIV in 8% of semen samples from men with an undetectable HIV viral load in plasma, but confirm the safety of assisted reproduction for HIV‐serodiscordant couples within a program with strict protocols for HIV treatment and testing of all semen before use.</description><identifier>ISSN: 0025-729X</identifier><identifier>EISSN: 1326-5377</identifier><identifier>DOI: 10.5694/mja11.10156</identifier><identifier>PMID: 22107010</identifier><identifier>CODEN: MJAUAJ</identifier><language>eng</language><publisher>Sydney: Australasian Medical Publishing Company</publisher><subject>Adult ; Australia ; Biological and medical sciences ; Cohort Studies ; Family Characteristics ; Female ; General aspects ; HIV Infections - prevention & control ; HIV Infections - transmission ; HIV Seronegativity ; HIV Seropositivity - transmission ; HIV-1 - isolation & purification ; HIV/AIDS ; Human viral diseases ; Humans ; Immunodeficiencies ; Immunodeficiencies. Immunoglobulinopathies ; Immunopathology ; Infant, Newborn ; Infectious Disease Transmission, Vertical - prevention & control ; Infectious diseases ; Male ; Medical sciences ; Middle Aged ; Pregnancy ; Pregnancy Complications, Infectious - prevention & control ; Pregnancy Complications, Infectious - virology ; Pregnancy Outcome ; Program Evaluation ; Reproduction (Biological) ; Reproductive Techniques, Assisted ; Retrospective Studies ; Risk Assessment ; RNA, Viral - analysis ; Semen ; Semen - virology ; Semen Analysis ; Transmission ; Urban Population ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Women's health ; Young Adult</subject><ispartof>Medical journal of Australia, 2011-11, Vol.195 (10), p.599-601</ispartof><rights>2011 AMPCo Pty Ltd. All rights reserved</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4229-47da51b8f3d5f1dcf57e42b043271e2af5bfc21b5fed67b430fed9c9671cb763</citedby><cites>FETCH-LOGICAL-c4229-47da51b8f3d5f1dcf57e42b043271e2af5bfc21b5fed67b430fed9c9671cb763</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.5694%2Fmja11.10156$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.5694%2Fmja11.10156$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25250322$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22107010$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Giles, Michelle L</creatorcontrib><creatorcontrib>Barak, Shlomi</creatorcontrib><creatorcontrib>Baker, Gordon</creatorcontrib><creatorcontrib>Tabrizi, Sepehr</creatorcontrib><creatorcontrib>Greengrass, Vicki</creatorcontrib><creatorcontrib>Bourne, Harold</creatorcontrib><creatorcontrib>Clarke, Gary N</creatorcontrib><creatorcontrib>Peak, Suellen A</creatorcontrib><creatorcontrib>Hoy, Jennifer F</creatorcontrib><creatorcontrib>Foster, Penelope</creatorcontrib><creatorcontrib>Knight, Rachael L</creatorcontrib><creatorcontrib>CVI Study Group</creatorcontrib><title>Outcomes from the first assisted reproduction program for HIV-serodiscordant couples in Australia</title><title>Medical journal of Australia</title><addtitle>Med J Aust</addtitle><description>Objective: To describe the clinical outcomes for all HIV‐serodiscordant couples attending an assisted reproduction program.
Design, setting and participants: Retrospective review of demographic, clinical and outcome data for all HIV‐serodiscordant couples who attended an assisted reproduction program at a tertiary hospital in Melbourne, between its commencement in 2003 and June 2010.
Main outcome measures: Pregnancies, miscarriages, births, HIV transmission to the HIV‐negative partner, semen quality and detection of HIV (HIV RNA and HIV DNA) in semen.
Results: As of June 2010, 39 HIV‐positive clients had proceeded to assisted reproduction after the initial consultation in the program. There were 162 completed cycles, with 26 pregnancies (clinical pregnancy rate per cycle, 16.2% for HIV‐positive men with an HIV‐negative partner, and 15.4% for HIV‐positive women). Of all 222 tested semen samples, 18 (8%) had HIV RNA detected despite these men receiving antiretroviral therapy and having an undetectable HIV viral load in plasma. Sperm velocity was significantly lower in HIV‐positive clients receiving combination antiretroviral therapy than in a control group of recipient‐recruited sperm donors (P = 0.01); there were no other significant differences in sperm quality between the two groups. No HIV transmission to babies or HIV‐negative partners occurred.
Conclusion: Our findings show detectable HIV in 8% of semen samples from men with an undetectable HIV viral load in plasma, but confirm the safety of assisted reproduction for HIV‐serodiscordant couples within a program with strict protocols for HIV treatment and testing of all semen before use.</description><subject>Adult</subject><subject>Australia</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>Family Characteristics</subject><subject>Female</subject><subject>General aspects</subject><subject>HIV Infections - prevention & control</subject><subject>HIV Infections - transmission</subject><subject>HIV Seronegativity</subject><subject>HIV Seropositivity - transmission</subject><subject>HIV-1 - isolation & purification</subject><subject>HIV/AIDS</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunodeficiencies</subject><subject>Immunodeficiencies. Immunoglobulinopathies</subject><subject>Immunopathology</subject><subject>Infant, Newborn</subject><subject>Infectious Disease Transmission, Vertical - prevention & control</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Infectious - prevention & control</subject><subject>Pregnancy Complications, Infectious - virology</subject><subject>Pregnancy Outcome</subject><subject>Program Evaluation</subject><subject>Reproduction (Biological)</subject><subject>Reproductive Techniques, Assisted</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>RNA, Viral - analysis</subject><subject>Semen</subject><subject>Semen - virology</subject><subject>Semen Analysis</subject><subject>Transmission</subject><subject>Urban Population</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><subject>Women's health</subject><subject>Young Adult</subject><issn>0025-729X</issn><issn>1326-5377</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1vFDEMhkcIRJfCiTvKBXGopiTOZNIcVxX9QEW9VIhb5MlHm2pmMiQZof57st0Fbpxsy49fW6-b5j2jp6JX3efpERk7ZZSJ_kWzYRz6VnApXzYbSkG0EtSPo-ZNzo-1ZALk6-YIgFFJGd00eLsWEyeXiU9xIuXBER9SLgRzDrk4S5JbUrSrKSHOpKb3CSfiYyJX19_b7GovZBOTxbkQE9dlrFphJts1l4RjwLfNK49jdu8O8bi5u_hyd37V3txeXp9vb1rTAai2kxYFG848t8Iza7yQroOBdhwkc4BeDN4AG4R3tpdDx2lNlFG9ZGaQPT9uPu1l64k_V5eLnupdbhxxdnHNWlGheqE4r-TJnjQp5pyc10sKE6YnzajeOaqfHdXPjlb6w0F3HSZn_7J_LKzAxwOA2eDoE84m5H-cAEE5QOXonvsVRvf0v53629ctCKXqyMV-JE2haFzQF_1QypK1xYI6zPUNu05M99rGsNPinPU6uLHCGigDCoqd8d8tO6e3</recordid><startdate>20111121</startdate><enddate>20111121</enddate><creator>Giles, Michelle L</creator><creator>Barak, Shlomi</creator><creator>Baker, Gordon</creator><creator>Tabrizi, Sepehr</creator><creator>Greengrass, Vicki</creator><creator>Bourne, Harold</creator><creator>Clarke, Gary N</creator><creator>Peak, Suellen A</creator><creator>Hoy, Jennifer F</creator><creator>Foster, Penelope</creator><creator>Knight, Rachael L</creator><general>Australasian Medical Publishing Company</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20111121</creationdate><title>Outcomes from the first assisted reproduction program for HIV-serodiscordant couples in Australia</title><author>Giles, Michelle L ; Barak, Shlomi ; Baker, Gordon ; Tabrizi, Sepehr ; Greengrass, Vicki ; Bourne, Harold ; Clarke, Gary N ; Peak, Suellen A ; Hoy, Jennifer F ; Foster, Penelope ; Knight, Rachael L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4229-47da51b8f3d5f1dcf57e42b043271e2af5bfc21b5fed67b430fed9c9671cb763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Australia</topic><topic>Biological and medical sciences</topic><topic>Cohort Studies</topic><topic>Family Characteristics</topic><topic>Female</topic><topic>General aspects</topic><topic>HIV Infections - prevention & control</topic><topic>HIV Infections - transmission</topic><topic>HIV Seronegativity</topic><topic>HIV Seropositivity - transmission</topic><topic>HIV-1 - isolation & purification</topic><topic>HIV/AIDS</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immunodeficiencies</topic><topic>Immunodeficiencies. Immunoglobulinopathies</topic><topic>Immunopathology</topic><topic>Infant, Newborn</topic><topic>Infectious Disease Transmission, Vertical - prevention & control</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Infectious - prevention & control</topic><topic>Pregnancy Complications, Infectious - virology</topic><topic>Pregnancy Outcome</topic><topic>Program Evaluation</topic><topic>Reproduction (Biological)</topic><topic>Reproductive Techniques, Assisted</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>RNA, Viral - analysis</topic><topic>Semen</topic><topic>Semen - virology</topic><topic>Semen Analysis</topic><topic>Transmission</topic><topic>Urban Population</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><topic>Women's health</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Giles, Michelle L</creatorcontrib><creatorcontrib>Barak, Shlomi</creatorcontrib><creatorcontrib>Baker, Gordon</creatorcontrib><creatorcontrib>Tabrizi, Sepehr</creatorcontrib><creatorcontrib>Greengrass, Vicki</creatorcontrib><creatorcontrib>Bourne, Harold</creatorcontrib><creatorcontrib>Clarke, Gary N</creatorcontrib><creatorcontrib>Peak, Suellen A</creatorcontrib><creatorcontrib>Hoy, Jennifer F</creatorcontrib><creatorcontrib>Foster, Penelope</creatorcontrib><creatorcontrib>Knight, Rachael L</creatorcontrib><creatorcontrib>CVI Study Group</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Medical journal of Australia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Giles, Michelle L</au><au>Barak, Shlomi</au><au>Baker, Gordon</au><au>Tabrizi, Sepehr</au><au>Greengrass, Vicki</au><au>Bourne, Harold</au><au>Clarke, Gary N</au><au>Peak, Suellen A</au><au>Hoy, Jennifer F</au><au>Foster, Penelope</au><au>Knight, Rachael L</au><aucorp>CVI Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes from the first assisted reproduction program for HIV-serodiscordant couples in Australia</atitle><jtitle>Medical journal of Australia</jtitle><addtitle>Med J Aust</addtitle><date>2011-11-21</date><risdate>2011</risdate><volume>195</volume><issue>10</issue><spage>599</spage><epage>601</epage><pages>599-601</pages><issn>0025-729X</issn><eissn>1326-5377</eissn><coden>MJAUAJ</coden><abstract>Objective: To describe the clinical outcomes for all HIV‐serodiscordant couples attending an assisted reproduction program.
Design, setting and participants: Retrospective review of demographic, clinical and outcome data for all HIV‐serodiscordant couples who attended an assisted reproduction program at a tertiary hospital in Melbourne, between its commencement in 2003 and June 2010.
Main outcome measures: Pregnancies, miscarriages, births, HIV transmission to the HIV‐negative partner, semen quality and detection of HIV (HIV RNA and HIV DNA) in semen.
Results: As of June 2010, 39 HIV‐positive clients had proceeded to assisted reproduction after the initial consultation in the program. There were 162 completed cycles, with 26 pregnancies (clinical pregnancy rate per cycle, 16.2% for HIV‐positive men with an HIV‐negative partner, and 15.4% for HIV‐positive women). Of all 222 tested semen samples, 18 (8%) had HIV RNA detected despite these men receiving antiretroviral therapy and having an undetectable HIV viral load in plasma. Sperm velocity was significantly lower in HIV‐positive clients receiving combination antiretroviral therapy than in a control group of recipient‐recruited sperm donors (P = 0.01); there were no other significant differences in sperm quality between the two groups. No HIV transmission to babies or HIV‐negative partners occurred.
Conclusion: Our findings show detectable HIV in 8% of semen samples from men with an undetectable HIV viral load in plasma, but confirm the safety of assisted reproduction for HIV‐serodiscordant couples within a program with strict protocols for HIV treatment and testing of all semen before use.</abstract><cop>Sydney</cop><pub>Australasian Medical Publishing Company</pub><pmid>22107010</pmid><doi>10.5694/mja11.10156</doi><tpages>3</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Medical journal of Australia, 2011-11, Vol.195 (10), p.599-601 |
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| subjects | Adult Australia Biological and medical sciences Cohort Studies Family Characteristics Female General aspects HIV Infections - prevention & control HIV Infections - transmission HIV Seronegativity HIV Seropositivity - transmission HIV-1 - isolation & purification HIV/AIDS Human viral diseases Humans Immunodeficiencies Immunodeficiencies. Immunoglobulinopathies Immunopathology Infant, Newborn Infectious Disease Transmission, Vertical - prevention & control Infectious diseases Male Medical sciences Middle Aged Pregnancy Pregnancy Complications, Infectious - prevention & control Pregnancy Complications, Infectious - virology Pregnancy Outcome Program Evaluation Reproduction (Biological) Reproductive Techniques, Assisted Retrospective Studies Risk Assessment RNA, Viral - analysis Semen Semen - virology Semen Analysis Transmission Urban Population Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Women's health Young Adult |
| title | Outcomes from the first assisted reproduction program for HIV-serodiscordant couples in Australia |
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