A study on hypogonadism in male HIV patients in northeastern part of India

Abstract

Context: After the introduction of highly active antiretroviral therapy (ART), the prevalence of hypogonadism among human immunodeficiency virus (HIV)-infected males is decreasing. Aims: The aim of this study was (i) to estimate the prevalence of hypogonadism among HIV-infected males and (ii) to determine the risk factors for hypogonadism. Settings and Design: This was a cross-sectional study undertaken at ART center of a medical Institute. Subjects and Methods: The study recruited HIV-infected males aged 18–65 years receiving ART. Patients with any debilitating chronic illness, diabetes mellitus, chronic smokers or alcoholic, currently on opioids, or methadone were excluded from the study. Androgen Deficiency in Aging Male (ADAM) questionnaire was used to screen patients for the possible presence of hypogonadism. For those screened positive on ADAM questionnaire underwent biochemical evaluation for serum total testosterone, luteinizing hormone (LH), and CD4 count. Statistical Analysis Used: The Chi-square test was used to compare different parameters. Pearson's correlation coefficient was used to assess any relationship between CD4 count, LH, and testosterone. P < 0.05 was considered statistically significant. Results: In the study, 426 were initially screened and 120 patients who had probable hypogonadism were further evaluated. The mean age of the patients was 41.61 years. The mean body mass index (BMI) of the patients was 22.47 kg/m 2 . The mean duration of ART was 6.13 years and the mean CD4 count was 442.63 cells/mm 3 . Hypogonadism was seen in 20 (23.3%) and majority (85.7%) had secondary hypogonadism. There was significant association between hypogonadism and CD4 count, but no association was found with BMI and duration of ART. Conclusions: Hypogonadism is seen in 23.3% of HIV-infected males. Majority (85.7%) had secondary hypogonadism. There was significant association of hypogonadism with lower CD4 count.

Prevalence of Hypogonadism and Associated Risk Factors among Newly Diagnosed ART Naïve HIV-Infected Males in Mwanza, Tanzania

“…Rochira et al [ 4 ] reported secondary hypogonadism in 86 percent of hypogonadal patients with testosterone <300 ng/dl. Similarly, in the study by Pongener et al [ 31 ] and Dutta et al [ 32 ], hypogonadotropic hypogonadism was found in 86% and 81% of hypogonadal patients, respectively. This observation could be due to invasion of the hypothalamic pituitary axis by the virus leading to impairment of its function.…”

Assessment of Clinical Factors and Serum Testosterone About Erectile Dysfunction in Hiv-Infected Men

“…The previous studies reported no significant correlation between the duration of ART and gonadal dysfunction [26][27][28]. Similarly, we found a weak negative correlation between ART regimen duration and ED when ST was abnormal (P=0.093).…”

Hypogonadism and liver fibrosis in HIV-infected patients

“…Hypogonadism is a relatively common finding in men with HIV, although its prevalence is at present lower comparing to the preantiretroviral therapy (ART) era [4,5]. Current estimates on the prevalence of hypogonadism in HIV-infected men generally range from 13 to 40% according to different study settings, mainly depending on the criteria and T-levels cut-offs used for its diagnosis [6,7]. Importantly, hypogonadism in HIV-infected men might result from either testicular disorder (primary hypogonadism) or hypothalamic-pituitary dysfunction (secondary hypogonadism); however, only few studies differentiated between these two forms by testing luteinizing hormone (LH) levels, which are elevated in the former case and low/normal in the latter.…”