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Assisted reproduction services : accessible screening and semen profiling of HIV-positive males
Dissertation (MSc)--University of Pretoria, 2013.
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| Format: | Thesis |
| Language: | English |
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University of Pretoria
2014
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| _version_ | 1867613538130853888 |
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| access_status_str | Open Access |
| author2 | Huyser, Carin |
| author_browse | Huyser, Carin |
| author_facet | Huyser, Carin |
| collection | Thesis |
| dc_rights_str_mv | © 2013 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. |
| description | Dissertation (MSc)--University of Pretoria, 2013. |
| format | Thesis |
| id | oai:repository.up.ac.za:2263/40837 |
| institution | University of Pretoria (South Africa) |
| language | English |
| last_indexed | 2026-06-10T12:37:44.183Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UPSpace — University of Pretoria Institutional Repository |
| publishDate | 2014 |
| publishDateRange | 2014 |
| publishDateSort | 2014 |
| publisher | University of Pretoria |
| publisherStr | University of Pretoria |
| record_format | dspace |
| source_str | UPSpace — University of Pretoria Institutional Repository |
| spelling | oai:repository.up.ac.za:2263/40837 Assisted reproduction services : accessible screening and semen profiling of HIV-positive males Huyser, Carin Richter, Karin Louise Stander, Melissa Human immunodeficiency virus (HIV) Public service sector Accessible ART Rapid screening Semen profiling Semen parameters Blood-borne virus Hepatitis B virus (HBV) Hepatitis C virus (HCV) Chlamydia trachomatis UCTD Dissertation (MSc)--University of Pretoria, 2013. Introduction International guidelines endorse the screening of patients for human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and Chlamydia trachomatis before assisted reproductive techniques (ART). At present no such guidelines exists in South Africa. At the Reproductive and Endocrine Unit (referred to as “the Unit”) of Steve Biko Academic Hospital, all patients with unknown HIV status are counselled and a blood sample is collected during the initial visit for automated laboratory based HIV screening. These HIV results are not available before semen samples are processed. Furthermore, patients are not screened for HBV, HCV and Chlamydia trachomatis. Couples attending the Unit are of a low to middle socio-economic status and experience financial constraints. Moreover, automated laboratory based assays are expensive to perform. Rapid testing is a cost effective and practical method from screening patients, with a 20–30 minute result turnover time. Until screening at the Unit is improved, the possible identification of semen characteristics that could indicate HIV infection would be a useful tool. Materials and Methods The following rapid point-of-care assays were evaluated: Determine® HIV-1/2 combo test (n=100), Determine® HBsAg test (n=100), DIAQUICK HCV kit (n=74), and the DIAQUICK Chlamydia trachomatis kit (n=30). For profiling, parameters from a basic semen analysis of HIV-positive males (n=60) were compared with HIV-negative males (n=60). Information pertaining to CD4 count, antiretroviral treatment and plasma viral load of HIV-positive males were analysed. Results From all patients included in the study, 8% tested positive for HIV. The risk of a female being HIV-positive was 3.73 times higher than for males. In the pilot study to explore rapid testing for HBV and HCV, 1% and 1.4% of patients tested positive respectively. When testing for Chlamydia trachomatis 31.3% of females, but no males tested positive. Comparing semen profiles, no significant differences were found between samples from HIV positive and negative males or between HIV positive males categorised by CD4 cell count (p>0.05). For the HIV-positive group with a detectable plasma HIV viral load (>40 copies/ml), a significant difference was observed in the semen viscosity (p=0.0460). Significant differences were noted in the sperm motility (immotile sperm p=0.0456, progressive sperm p=0.0192) of patients receiving antiretroviral (ARV) therapy. Discussion and Conclusion The use of rapid testing is an acceptable and feasible option for improving current screening protocols at the Unit. The absence of definite alterations in the semen characteristics of HIV-positive men further motivates the need for a simpler, point-of-care screening protocol. The prevalence of HBV was lower than that reported in the general population of South Africa and further investigation is needed. Although the sample size was small, HCV prevalence was similar to that of the general population. One third of females tested positive for Chlamydia trachomatis. The methodology used was possibly not appropriate for males. This study highlighted the need for guidelines that address the specialised needs of ART clinics in resource-limited and developing countries with a high HIV prevalence. gm2014 Obstetrics and Gynaecology unrestricted 2014-07-17T12:15:08Z 2014-07-17T12:15:08Z 2014-04-25 2013 Dissertation Stander, M 2013, Assisted reproduction services : accessible screening and semen profiling of HIV-positive males, MSc dissertation, University of Pretoria, Pretoria, viewed yymmdd <http://hdl.handle.net/2263/40837> E14/4/278/gm http://hdl.handle.net/2263/40837 en © 2013 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. application/pdf University of Pretoria |
| spellingShingle | Human immunodeficiency virus (HIV) Public service sector Accessible ART Rapid screening Semen profiling Semen parameters Blood-borne virus Hepatitis B virus (HBV) Hepatitis C virus (HCV) Chlamydia trachomatis UCTD Assisted reproduction services : accessible screening and semen profiling of HIV-positive males |
| title | Assisted reproduction services : accessible screening and semen profiling of HIV-positive males |
| title_full | Assisted reproduction services : accessible screening and semen profiling of HIV-positive males |
| title_fullStr | Assisted reproduction services : accessible screening and semen profiling of HIV-positive males |
| title_full_unstemmed | Assisted reproduction services : accessible screening and semen profiling of HIV-positive males |
| title_short | Assisted reproduction services : accessible screening and semen profiling of HIV-positive males |
| title_sort | assisted reproduction services accessible screening and semen profiling of hiv positive males |
| topic | Human immunodeficiency virus (HIV) Public service sector Accessible ART Rapid screening Semen profiling Semen parameters Blood-borne virus Hepatitis B virus (HBV) Hepatitis C virus (HCV) Chlamydia trachomatis UCTD |
| url | http://hdl.handle.net/2263/40837 |