Prevalence of testosterone deficiency in HIV-infected men under antiretroviral therapy

BMC Infectious Diseases

Research Article

Bernardo Sousa-Pinto¹  Pedro Souteiro²  Davide Carvalho³  Paula Freitas³  Carolina Germana Silva⁴  Ana Rita Gomes⁴  António Sarmento⁵  Francisco Almeida⁵ 

[1] Department of Health Information and Decision Sciences, Faculty of Medicine (CIDES), University of Porto, Rua Dr. Placido da Costa, 4200-450, Porto, Portugal;Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Rua Dr. Placido da Costa, 4200-450, Porto, Portugal;Endocrinology, Diabetes and Metabolism Department, Centro Hospitalar São João, Porto, Portugal;Endocrinology, Diabetes and Metabolism Department, Centro Hospitalar São João, Porto, Portugal;Faculty of Medicine, i3S - Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal;Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal;Infectious Diseases Department, Centro Hospitalar São João, Faculty of Medicine, University of Porto, Porto, Portugal;

关键词: HIV infection;    Hypogonadism;    Lipodystrophy;    Cardiovascular risk;   

DOI  :  10.1186/s12879-016-1892-5

 received in 2016-03-10, accepted in 2016-10-01,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe prevalence of hypogonadism in HIV-infected patients is still a matter of debate as there is no standardized consensual diagnostic method. In addition, the etiology and endocrine/metabolic implications of hypogonadism in this population remain controversial. This study aims to determine the prevalence of testosterone deficiency in a single-site hospital and to evaluate its association with potential risk factors, lipodystrophy, metabolic syndrome, and cardiovascular risk.MethodsThis study analyzed 245 HIV-infected men on combined antiretroviral therapy. Patients with low total testosterone (TT) levels (<2.8 ng/mL) and/or low calculated free testosterone (FT) levels (<6.5 ng/dL) were considered testosterone deficient. According to their LH and FSH levels, patients were classified as having hypogonadotropic or hypergonadotropic dysfunction. Other clinical, anthropometric, and analytic parameters were also collected and analyzed.ResultsThe prevalence of testosterone deficiency in our population was 29.4 %. Among them, 56.9 % had hypogonadotropic dysfunction and 43.1 % presented with hypergonadotropic dysfunction. Patients with testosterone deficiency were older (p < 0.001), had higher HbA1c levels (p = 0.016) and higher systolic blood pressure (p = 0.007). Patients with lower testosterone levels had higher prevalence of isolated central fat accumulation (p = 0.015) and had higher median cardiovascular risk at 10 years as measured by the Framingham Risk Score (p = 0.004) and 10-Year ASCVD risk (p = 0.002).ConclusionsThe prevalence of testosterone deficiency in this HIV population is high, with hypogonadotropic dysfunction being responsible for the majority of cases. Testosterone deficiency might predispose to, or be involved, in the pathogenesis of HIV-associated lipodystrophy. Patients with low testosterone levels have higher cardiovascular risk, highlighting the importance of early diagnosis of this condition.

【 授权许可】

CC BY   
© The Author(s). 2016