Introduction: HIV infection is suspected to influence not only immune cells but also the genital organs. The influence of HIV infection on semen parameters, which assess male fertility, was studied.
Methods: 26 semen specimens were obtained from 18 HIV seropositive men. Sperm concentration and percentage motility were studied. The viral loads in both semen and blood were simultaneously measured at intake. The experiences and methods of medical treatment, and values of CD4 as well as the patients' background were considered in determining whether the detection of HIV and its influence on fertility is in association withsuch clinical factors.
Results and Discussion: It was suggested that HIV infection possibly influenced male fertility. Moreover, it was surmised that medical treatment possibly reduces the viral loads in semen. However, clinical factors showed no beneficial interrelation with semen parame ters.

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Objective: The number of HIV serodiscordant couples, an HIV-1 infected husband andan uninfected wife who wish to have their own children, is growing. Because HIV is spread primarily through sexual contact, to prevent HIV transmission and to have a child is a rather contradictory matter. If the processed semen of the husband can be used to impregnate the seronegative wife without infection, this could be a solution.
Methods: Three groups of samples, semen obtained from HIV-positive male volunteers (group-I), seronegative semen plus HIV-positive serum (group-II), and HIV-positiveserum only (group-III), were treated with Sil-Select followed by swim-up method. HIV viral load was measured using a nested PCR (detection limit: 5 copies/tube).
Results: 55.6% of group-I and all of group-III proved negative. 50.0% of group-II, however, was still positive.
Discussion: Those treated with the combination methods had an obviously lowered viral load. But immediate attachment of virus to spermatozoon is possible. Production of viral-free spermatozoon through the method still seems difficult. If the techniqueto exclude HIV from semen is perfected and thus healthy semen can be supplied, there is be nodoubt the assisted reproductive technology can be adapted to those who desire a family. Futher studies are needed.

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Background: As the number of HIV-infected individuals of reproductive age increases, the number of discordant couples (HIV positive husband and negative wife) who wish to have their own children is also increasing.
Method: We made inquires to such couples about their will and awareness, and discussed these issues with specialists of several fields which included medicine, law, ethics, and human rights as well as patients.
Result and Conclusion: Among the discordanct couples, there were some who strongly desire their own children even though they know the risk of transmission. However, complete eradication of HIV from semen by semen processing is still impossible at the present. Furthermore, there are still many medical, social, and ethical issues to be made clear before implementation of an intrauterine insemination technique.

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Objective: The CD4 cell counts, plasma HIV-RNA levels and the use of antiretroviral therapy among patients with HIV infection through blood products in 1999 were analyzed.
Materials and Methods: The data reported from physicians in 1999 were available. The number of patients with HIV infection through blood products was 658.
Results: Among HIV-infected patients, CD4 cell counts of 350 or more per cubic millimeter was 52%. Plasma HIV-RNA levels of 999 copies/ml or less was 61%. The use of a regimen with 2 reverse transcriptase inhibitors plus one protease inhibitor was 39% and no use of antiretroviral therapy was 32%. Complete compliance with antiretroviral therapy was 85%. Of HIV-infected patients with CD4 cell counts of 200 or less, 52% had the regimen of trimethoprim-sulfamethoxazole.
Conclusion: The CD4 cell counts and plasma HIV-RNA levels among many HIV-infected persons were well-controlled. The probabilities of improvement for preventing AIDSand opportunistic infections were suggested.

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Objective: We aimed to investigate trends in CD4 cell counts, plasma HIV-RNA levels and the use of antiretroviral treatments, as well as those relationships, among patients with HIV infection through blood products.
Materials and Methods: The data were available from the second quarter of 1993 through the first quarter of 1999. The numbers of patients with HIV infection through blood products were 417 on 1/1/1994 and 604 on 4/1/1997.
Results: The number of patients who developed AIDS (including fatalities) per quarter declined from 8.7 (average from the second quarter of 1993 to the first quarter of 1997) to 1.8 (from the second quarter of 1997 to the first quarter of 1999). The median value of CD4 cell counts decreased from 287 per cubic millimeter in the second quarter of 1993 to 172 in the third quarter of 1996, but increased from 183 in the last quarter of 1996 to 240 in the first quarter of 1999. There was a downward trend in HIV-RNA virus level from 2, 600 copies/ml in the second quarter of 1997 to 685 in the first quarter of 1999. The proportion of patients who were treated with therapeutic regimens that include two reverse transcriptase inhibitors (RTIs) and one protease inhibitor (PI) increased from 15.1% to 36.6% during the same period. The relationships between the changes of antiretroviral therapy and the improvements of those parameters were suggested.
Conclusion: The data showed that since 1997, combination therapies including two RTIs and one PI were used increasingly, and both CD4 cell counts and plasma HIV-RNA levels improved in this population. It was suggested that improvements of those parameters were attributable to the increasing use of those regimens.

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