First Line Anti-Retroviral (ARV) Drugs Disrupt Follicular Development in Female Wistar Rats

INTRODUCTION: There are genuine concerns that long-term use of antiretroviral drugs may be associated with reproductive complications in females. This study aimed to ascertain the effect of highly active antiretroviral drugs on the ovarian reserve and reproductive potential of female Wistar rats and by extension to HIV-positive human females. METHODS: A total of 25 female Wistar rats, weighing between 140g-162g, were randomly allotted into non-intervention and intervention groups, receiving the anti-retroviral drugs, Efavirenz (EFV), Tenofovir Disoproxil Fumarate (TDF), Lamivudine (3TC), and a fixed-dose combination (FDC). The dosage was administered orally at 8 am daily for 4 weeks. Serum concentrations of anti-Mullerian hormone (AMH), follicle stimulating hormone (FSH), luteinising hormone (LH) and estradiol were measured using standard biochemical techniques (ELISA). Follicular counts were made on fixed ovarian tissue from the sacrificed rats. RESULTS: The mean AMH level for the control group and the EFV, TDF, 3TC, and the FDC groups were 11.20, 6.75, 7.30, 8.27, and 6.60 pmol/L, respectively. The EFV and FDC groups had the lowest AMH, compared to the other groups, but there was no statistically significant difference in AMH across the groups. The mean count of antral follicles was significantly lower in the group that received EFV when compared to the other groups. The corpus luteal count was significantly higher in the control group than in the intervention groups (p=0.033). CONCLUSION: The study demonstrated a disruption in the reproductive hormones of female Wistar rats receiving antiretroviral regimens containing EFV. Clinical studies are required to determine if these changes are seen in women receiving EFV-based treatment, as this may compromise reproductive function and predispose them to early menopause.