Efavirenz-based highly active antiretroviral therapy disrupts folliculogenesis: evidence from 48 women of reproductive age
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Introduction: Interventions to eliminate mother-to-child transmission of HIV have led to a low vertical transmission rate and improved reproductive outcomes for women living with HIV. There are genuine concerns about the long-term effect of antiretroviral drugs (ARVs) on the future reproductive function of females, as female rodent models have shown impaired folliculogenesis when treated with contemporary ARVs. There is a need to investigate the effect of contemporary ARVs on the ovarian reserve of patients receiving ARVs.
Methods: This cross-sectional study was conducted on women between the reproductive age of 15 and 45 years, forming three study categories. Group 1 comprised HIV-positive patients already on efavirenz-based antiretroviral therapy. Group 2 comprised HIV-positive patients who were naïve to ARVs at the time of recruitment. Group 3 comprised HIV-negative women within the reproductive age range not on ARVs (controls). We used t-test and ANOVA for statistical analysis. The alpha level was significant if the p-value was <0.05.
Results: The average value of follicle-stimulating hormone was significantly higher in the HIV-positive group receiving ARVs, compared to the control group (p = 0.039). The average value of luteinizing hormone was significantly higher in the HIV-positive group receiving ARVs when compared to the HIV-negative group (p = 0.014). The antral follicular count was significantly reduced in the group receiving ARVs, compared to HIV-positive individuals naïve to ARVs and HIV-negative controls (p = 0.009).
Conclusion: Evidence from this study suggests that efavirenz-based antiretroviral medication disrupts follicular development.
Methods: This cross-sectional study was conducted on women between the reproductive age of 15 and 45 years, forming three study categories. Group 1 comprised HIV-positive patients already on efavirenz-based antiretroviral therapy. Group 2 comprised HIV-positive patients who were naïve to ARVs at the time of recruitment. Group 3 comprised HIV-negative women within the reproductive age range not on ARVs (controls). We used t-test and ANOVA for statistical analysis. The alpha level was significant if the p-value was <0.05.
Results: The average value of follicle-stimulating hormone was significantly higher in the HIV-positive group receiving ARVs, compared to the control group (p = 0.039). The average value of luteinizing hormone was significantly higher in the HIV-positive group receiving ARVs when compared to the HIV-negative group (p = 0.014). The antral follicular count was significantly reduced in the group receiving ARVs, compared to HIV-positive individuals naïve to ARVs and HIV-negative controls (p = 0.009).
Conclusion: Evidence from this study suggests that efavirenz-based antiretroviral medication disrupts follicular development.
Date Issued
2025-02-24
Date Acceptance
2025-02-01
Citation
Cureus, 2025, 17 (2)
ISSN
2168-8184
Publisher
Springer Science and Business Media LLC
Journal / Book Title
Cureus
Volume
17
Issue
2
Copyright Statement
© Copyright 2025 Ohihoin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
License URL
Identifier
10.7759/cureus.79597
Subjects
anti-retroviral drugs
folliculogenesis
hiv
reproductive age
reproductive outcome
Publication Status
Published
Article Number
e79597
Date Publish Online
2025-02-24