Changes in the Hypothalamic-Pituitary-Gonadal Axis in Human Immunodeficiency Virus-Infected Homosexual Men*

Abstract

Serum total testosterone, total 17 beta-estradiol, LH, FSH, and PRL concentrations were measured by RIA in 59 homosexual men infected with the human immunodeficiency virus (32 clinically healthy antibody-positive men (HH+), 20 men with acquired immune deficiency syndrome (AIDS), and 7 men with AIDS-related complex (ARC). The results were compared with those of 26 antibody-negative homosexual men (HH-) who served as controls. The mean serum total testosterone concentration was significantly lower in the men with AIDS [414 +/- 230 (+/- SD) ng/dL (14.5 +/- 8.0)] than in the HH- men [550 +/- 172 ng/dL (19.0 +/- 6.0 nmol/L); P less than 0.05]. The mean serum LH level was significantly higher in the men with AIDS (26 +/- 14 vs. 14 +/- 4 IU/L in HH- men; P less than 0.01) and slightly but significantly higher in the men with ARC (19 +/- 8 IU/L; 0.10 greater than P greater than 0.05). Serum FSH also was significantly higher in the men with AIDS (P less than 0.05). Serum PRL was significantly higher in the men with ARC (10 +/- 2 micrograms/L; P less than 0.05) and AIDS (16 +/- 10 micrograms/L; P less than 0.001) than in the HH- men (8 +/- 3 micrograms/L). Serum sex hormone-binding globulin levels were similar in HH- men and men with AIDS as were serum T responses to hCG administration for 2 days. These results suggest that alterations of the hypothalamic-pituitary-gonadal axis indicative of primary hypogonadism accompany human immunodeficiency virus infection in homosexual men.

Post-weaning breast milk HIV-1 viral load, blood prolactin levels and breast milk volume

“…The level of prolactin in HIV-infected lactating women has not previously been measured. The role of prolactin in lactational amenorrhea in the absence of HIV-infection is well established and, from our results, appears to be intact among HIV-infected, lactating or recently weaned women, despite the presence of hyperprolactinemia found among HIV-infected men and women [32,33]. However, the significance of increased prolactin in these circumstances remains controversial [36].…”

“…It has been shown to increase significantly in response to the stimulus of breastfeeding [26][27][28][29], diminish with the onset of non-exclusive breastfeeding [30] and fall precipitously after suckling has ended [31]. Hyperprolactinemia is also known to occur in up to one-fifth of HIVinfected non-lactating individuals [32,33] but has not been assessed in lactating HIV-infected women.…”

Viruses in the Mammalian Male Genital Tract and Their Effects on the Reproductive System

“…However, other studies found no significant abnormality in the hypothalamic-pituitary axis (253,286). The low serum testosterone levels in men with AIDS are in some cases associated with high serum LH and FSH levels, implying that there is primary testicular failure (79). A possible reason for the testosterone secretory defect in these men is suggested by reports that cytokines released by the activated phagocytic cells of the immune system inhibit the steroidogenic response to human chorionic gonadotropin in vitro and presumably also the response to LH in vivo (57).…”

Gonadal function in men with chronic illness

“…Therapy with testosterone will always need to be carefully considered as there will always remain the potential for abuse by men wanting a cure for chronic fatigue and lack of energy or seeking their lost youth. Barreca et al, 1983Griggs et al, 1985a,b, 1989 Normal testosterone Increased Warner et al, 1992 DHT resistance …”

“…low CD4 count and weight loss (Raffi et al, 1991). Others have shown similarly reduced testosterone levels in patients with AIDS, but elevated gonadotrophins, suggestive of a primary gonadal defect (Croxson et al, 1989), while evidence of testicular atrophy and impaired spermatogenesis has been found in postmortem studies without inflammation or infection. (Welch et al, 1984).…”