An association of human herpesviruses and human papillomaviruses with abnormal key sperm indicators in men with infertility and inflammatory diseases of the urogenital tract
Objective. To investigate the spread of human herpesviruses (HHV) and high-risk human papillomaviruses (hrHPV) in the urogenital tract, by analyzing their viral load in men with infertility and inflammatory diseases of the urogenital tract, and to evaluate the effect of these viruses on the quality of sperm. Subjects and methods. A total of 605 patients with infertility and inflammatory diseases of the urogenital tract were examined. A real-time PCR assay was used to determine viral DNA in the clinical materials (ejaculate, urethral scrape, and prostate fluid). The key indicators of sperm were studied according to the WHO guidelines). Results. HHV DNA and hrHPV DNA in the ejaculate were detected in a total of 142 (32.5%) patients. Examination of the three materials (ejaculate, urethral scrape, and prostate fluid) from patients with an exacerbation of chronic prostatitis showed that 67 (51.9%) cases had viral DNA. HHV in mono- and mixed infections were found in 98 (22.4%) ejaculates, HHV-6 being more common than cytomegalovirus and Epstein-Barr virus ((10.3, 6.6, and 5.5%, respectively). hrHPV DNA was detected in the ejaculates of 78 (17.8%) patients. Viral DNA was found in the ejaculate of none of the healthy men. There were combinations of the viruses in the ejaculates in 6.9% of the patients, these being statistically significantly more frequent in the men with inflammatory diseases of the urogenital tract than in those with infertility, but without inflammatory diseases. Quantitative analysis of viral DNA showed that more than 30% of the ejaculates contained hrHPV at a clinical concentration (> 3 lg/10<sup>5</sup> cells) and 10.5% had these at a high risk concentrations (> 5 lg/10<sup>5</sup> cells). Comparative analysis of spermograms established a statistically significant decrease in sperm motility and a smaller number of morphologically normal forms of spermatozoids in the patients with inflammatory diseases of the urogenital tract. Conclusion. Detection of the viruses in the male urogenital tract is associated with diminished fertility and with a high viral load suggests that there is a high risk for the unfavorable development of infect, including oncogenesis. The findings allow for the recommendation of virological examination of patients with infertility and inflammatory diseases of the urogenital tract, by applying molecular methods for quantitative analysis.