Metabolic syndrome and endocrine status in HIV-infected transwomen

Pommier, Jean-David; Laouénan, Cédric; Michard, F.; Papot, Emmanuelle; Boutten, Anne; Peytavin, Gilles; Ghander, C.; Lariven, Sylvie; Castanedo, Gerald; Moho, David; Landman, Roland; Phung, Bao; Perez, Estela; Zélie, Julia; Descamps, Diane; Roland-Nicaise, Pascale; Gac, Sylvie Le; Yazdanpanah, Yazdan; Gadrey, Jean; Yéni, Patrick

doi:10.1097/qad.0000000000002152

Cited by 10 publications

(3 citation statements)

References 49 publications

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“…In a chart review, Sokalski et al [22] noted a trend towards a higher prevalence of adrenal insufficiency among women living with HIV compared with general population data, but the small sample size prevented statistical comparison. Finally, Pommier et al found significantly lower morning serum cortisol and higher rates of primary adrenal insufficiency upon ACTH stimulation in transgender women living with HIV compared with cisgender men living with HIV [23]. Although several studies noted a trend towards a higher prevalence of low cortisol in people with HIV, a lack of control groups and inconsistent results limited our ability to conclude that people with HIV are at higher risk for clinically significant adrenal insufficiency.…”

Section: Resultsmentioning

confidence: 99%

“…Pommier et. al found that transgender women living with HIV were more likely than cisgender men with HIV to have primary adrenal insufficiency (Table 2) and that 60% of transgender women with HIV with adrenal insufficiency used injectable estrogen‐progestin or antiandrogen [23]. Exogenous estrogens are expected to increase transcortin and thus cortisol levels, as reported by Fuss et al in transwomen on gender‐affirming hormone therapy [55], suggesting that factors other than hormone treatment may be affecting the findings reported by Pommier et al Overall, it appears that both cis‐ and transgender women living with HIV are more likely to have hypocortisolism and an abnormal cortisol axis response to stress, but the mechanism behind this remains unknown.…”

Section: Resultsmentioning

confidence: 99%

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Stressing the need for validated measures of cortisol in HIV research: A scoping review

et al. 2022

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Objectives People living with HIV experience numerous endocrine abnormalities and psychosocial stressors. However, interactions between HIV, cortisol levels, and health outcomes have not been well described among people living with HIV on effective therapy. Furthermore, methods for measuring cortisol are disparate across studies. We describe the literature reporting cortisol levels in people living with HIV, describe methods to measure cortisol, and explore how this relates to health outcomes. Methods We searched the PubMed database for articles published in the past 20 years regarding HIV and cortisol with ≥50% of participants on antiretroviral therapies. Articles included observational, case‐control, cross‐sectional, and randomized controlled trials analyzing cortisol by any method. Studies were excluded if abnormal cortisol was due to medications or other infections. Variables were extracted from selected studies and their quality was assessed using the Newcastle–Ottawa Scale. Results In total, 19 articles were selected and included, covering the prevalence of abnormal cortisol (n = 4), exercise (n = 4), metabolic syndrome and/or cardiovascular disease (n = 2), mental health and cognition (n = 9), and sex/gender (n = 6). Cortisol was measured in serum (n = 7), saliva (n = 8), urine (n = 2), and hair (n = 3) specimens. Comparisons between people with and without HIV were inconsistent, with some evidence that people with HIV have increased rates of hypocortisolism. Depression and cognitive decline may be associated with cortisol excess, whereas anxiety and metabolic disease may be related to low cortisol; more data are needed to confirm these relationships. Conclusions Data on cortisol levels in the era of antiretroviral therapy remain sparse. Future studies should include controls without HIV, appropriately timed sample collection, and consideration of sex/gender and psychosocial factors.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Stressing the need for validated measures of cortisol in HIV research: A scoping review

et al. 2022

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“…However, data on possible interactions are scarce 19 and contradictory. 20 TRHIV women are more adherent to ART when they have few side effects and when female hormone effectiveness is not affected. 21 With regard to transgender men, little information is available about interactions between masculinising hormone and ART.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Living conditions, HIV and gender affirmation care pathways of transgender people living with HIV in France: a nationwide, comprehensive, cross-sectional, community-based research protocol (ANRS Trans&HIV)

Mora

Rincon²,

Bourrelly

et al. 2021

BMJ Open

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IntroductionTransgender identity is poorly accepted in France, and data on living conditions and the daily difficulties transgender people encounter are scarce. This lack of data reinforces their invisibility in social life, contributes to their stigmatisation and probably increases the burden of HIV infection, especially for HIV-positive transgender people (TRHIV). The main objective of the community-based research study ANRS Trans&HIV is to identify personal and social situations of vulnerability in TRHIV, the obstacles they encounter in terms of access to and retention in medical care, and their gender affirmation and HIV care needs.Methods and analysisANRS Trans&HIV is a national, comprehensive, cross-sectional survey of all TRHIV currently being followed in HIV care units in France. TRHIV women are exclusively included in the quantitative component, and TRHIV men in the qualitative component. Data are collected by community-based interviewers and will be analysed to explore patient care pathways and living conditions in the TRHIV population with regard to gender affirmation and HIV. Data collection began in October 2020 and should be completed in December 2021. The statistical analyses techniques used will be adapted to each of the study’s objectives and to the type of data collected (cross-sectional (questionnaires) and retrospective (biographical trajectory)). The study’s results will provide a greater understanding of TRHIV health needs in order to suggest possible national recommendations for comprehensive HIV and gender affirmation medical care.Ethics and disseminationANRS Trans&HIV was approved by Inserm’s Ethical Evaluation Committee (no 20-694 on 12 May 2020) and is registered with the National Commission on Informatics and Liberty under number 2518030720. Potential participants are informed about the study through an information note provided by their attending HIV physician. All results published in peer-reviewed journals will be disseminated to the HIV transgender community, institutional stakeholders and healthcare providers.Trial registration numberNCT04849767.

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Conceptualizing the Risks of Coronary Heart Disease and Heart Failure Among People Aging with HIV: Sex-Specific Considerations

Abelman

Mugo

Zanni

2019

Curr Treat Options Cardio Med

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Metabolic syndrome and endocrine status in HIV-infected transwomen

Cited by 10 publications

References 49 publications

Stressing the need for validated measures of cortisol in HIV research: A scoping review

Stressing the need for validated measures of cortisol in HIV research: A scoping review

Living conditions, HIV and gender affirmation care pathways of transgender people living with HIV in France: a nationwide, comprehensive, cross-sectional, community-based research protocol (ANRS Trans&HIV)

Conceptualizing the Risks of Coronary Heart Disease and Heart Failure Among People Aging with HIV: Sex-Specific Considerations

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