Sperm washing to prevent HIV transmission from HIV-infected men but allowing conception in sero-discordant couples.

Authors:
Dr Ahizechukwu C Eke, MD, MPH, FWACS
Dr Ahizechukwu C Eke, MD, MPH, FWACS
Division of Maternal Fetal Medicine & Clinical Pharmacology, Johns Hopkins University School of Medicine, 600 N Wolfe Street
Maternal Fetal Medicine
Baltimore, Maryland | United States

Cochrane Database Syst Rev 2011 Jan 19(1):CD008498. Epub 2011 Jan 19.

Department of Health Policy and Management, Masters in Public Health (MPH), Harvard School of Public Health (HSPH), 677 Huntington Avenue, Boston, Massachusetts, USA, 02115.

Background: Sperm washing is a term used to describe the process in which individual spermatozoa are separated from the seminal fluid. Sperm washing is used to prevent HIV transmission but allow conception in sero-discordant couples, where the male is HIV positive, but the female is HIV negative. This procedure is based on the observation that HIV cannot attach itself to spermatozoa, but it can be found in the fluid and cells surrounding spermatozoa.

Objectives: To determine the benefits and harms of sperm washing of HIV-infected males when used to prevent the transmission of HIV but allowing conception in the HIV-negative female.

Search Strategy: We searched the Cochrane HIV/AIDS Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, SCORPUS, AIDsearch, AJOL, LILACS and INDEX MEDICUS. We also searched the following conference proceedings for relevant abstracts:The International AIDS Conference; The Conference on Retroviruses and Opportunistic Infections (CROI); The British HIV Association (BHIVA) Conference; The International Conference of Obstetricians and Gynecologists (FIGO); The American Academy of HIV Medicine Conference; The Australasian HIV/AIDS Conference; The American Society for Reproductive Medicine (ASRM) conferences and website; The European Society for Human Reproduction and Embryology (ESHRE) conferences and websites, and the British Fertility Society (BFS) conferences and website. We also conducted a search of the website: www.ClinicalTrials.gov. The date of the most recent Cochrane HIV/AIDS Group Controlled Trials Register search was on the 10th of November, 2010.

Selection Criteria: We preferentially looked for randomised or quasi-randomised controlled trials on sperm washing, aimed at preventing HIV transmission from HIV infected men but allowing conception in sero-discordant couples, irrespective of publication status, year of publication, or language in the review.

Data Collection And Analysis: No relevant trials were identified for inclusion in this review.

Main Results: Forty four studies were identified, but none of them were suitable for inclusion in this review.

Authors' Conclusions: Reports on the use of sperm washing to prevent HIV transmission from HIV infected men but allowing conception in sero-discordant couples is currently limited to observational studies. No randomised controlled trial has assessed the benefit or risk of sperm washing to prevent HIV transmission from HIV infected men but allow conception in sero-discordant couples. Thus, this systematic review identifies the need for a multicentre randomised controlled trial assessing the benefits and possible risks of sperm washing in preventing HIV transmission from HIV infected men but allow conception in sero-discordant couples.

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http://dx.doi.org/10.1002/14651858.CD008498.pub2DOI Listing
January 2011
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References

(Supplied by CrossRef)
HIV particles detected in spermatozoa of patients with AIDS
Baccetti et al.
Journal of Submicroscopic Cytologic Pathology 1991
Natural pregnancies in HIV-serodiscordant couples receiving successful antiretroviral therapy
Barreiro et al.
Journal of Acquired Immune Deficiency Syndrome 2006
Effectiveness of highly active antiretroviral therapy in reducing heterosexual transmission of HIV
Castilla et al.
Journal of Acquired Immune Deficiency Syndrome 2005
Fertility desires and intentions of HIV-positive men and women
Chen et al.
Family Planning Perspectives 2001

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