Sexual hormones in HIV-infected patients: the influence of antiretroviral therapy

Collazos, Julio; Martínez, Eduardo; Mayo, José; Ibarra, Sofía

doi:10.1097/00002030-200204120-00018

Cited by 41 publications

(41 citation statements)

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“…Prevalence of sexual dysfunction is widespread with most (89%) HIV positive homosexual and bisexual men reporting a decrease or loss of libido, 86% having erectile dysfunction, 68% reporting orgasmic perturbation, and 59% reporting ejaculation difficulties (Lallemand et al, 2002). Although the mechanisms of these problems are still under investigation, in large studies these side effects are particularly prevalent in those receiving a regimen containing protease inhibitors (PIs) (27.1% vs. 3.8% for untreated patients) (Collazos, Martinez, Mayo, & Ibarra, 2002;Schrooten et al, 2001;Trotta et al, 2003). The data were more striking, as a significantly larger number of PI-experienced men reported sexual problems than antiretroviral naïve patients (Schrooten et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

HIV Treatment Adherence and Sexual Functioning

2007

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To our knowledge, no studies have considered the bidirectional relationship between HIV infected patients' social/sexual lives and HAART adherence. To determine it's potential impact the study sample consisted of 135 men starting HAART and being followed for 6 months. Twenty percent of men enrolled in the study self-reported non-adherence. Non-adherent patients reported a greater number and severity of adverse effects such as gastrointestinal and body changes. All participants were aware of these risks, requested support, and were advised by the health care providers. As many as 26% of the HIV infected men, at the second visit, reported sexual dysfunction and none received information regarding the possibility of this side effect. Of importance, patients reporting sexual dysfunction, were more likely to report not being fully adherent to the medication (RR=2.46 95% CI 1.3-4.7; P=0.04). Of most concern, none of the men reported looking for medical advice.

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Section: Introductionmentioning

confidence: 99%

HIV Treatment Adherence and Sexual Functioning

2007

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“…This increase in gonadotropin levels, however, did not result in increased fT. Similarly, most [18] but not all [19] previous reports described no effect of cART on hypogonadism. The limitations of our study include the use of stored plasma samples, because they were not all taken in a morning fasting state.…”

Section: Discussionmentioning

confidence: 57%

Androgen and gonadotropin patterns differ in HIV‐1‐infected men who develop lipoatrophy during antiretroviral therapy: a case–control study

Wunder¹,

Fux

Bersinger³

et al. 2008

HIV Medicine

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ObjectivesWe compared androgen and gonadotropin values in HIV-infected men who did and did not develop lipoatrophy on combination antiretroviral therapy (cART). MethodsFrom a population of 136 treatment-naïve male Caucasians under successful zidovudine/ lamivudine-based cART, the 10 patients developing lipoatrophy (cases) were compared with 87 randomly chosen controls. Plasma levels of free testosterone (fT), dehydroepiandrosterone (DHEA), follicle-stimulating hormone and luteinizing hormone (LH) were measured at baseline and after 2 years of cART. ResultsAt baseline, 60% of the cases and 71% of the controls showed abnormally low fT values. LH levels were normal or low in 67 and 94% of the patients, respectively, indicating a disturbance of the hypothalamic-pituitary-gonadal axis. fT levels did not significantly change after 2 years of cART. Cases showed a significant increase in LH levels, while controls showed a significant increase in DHEA levels. In a multivariate logistic regression model, lipoatrophy was associated with higher baseline DHEA levels (P 5 0.04), an increase in LH levels during cART (P 5 0.001), a lower body mass index and greater age. ConclusionsHypogonadism is present in the majority of HIV-infected patients. The development of cART-related lipoatrophy is associated with an increase in LH and a lack of increase in DHEA levels. 427The lipodystrophy syndrome represents a well-known adverse effect of cART consisting of fat redistribution abnormalities, insulin resistance and dyslipidaemia [4,5]. Lipodystrophy includes central lipohypertrophy and peripheral lipoatrophy. The latter has been associated with the toxic effects of nucleoside reverse transcriptase inhibitors (NRTIs) on mitochondria [6][7][8] and cART-related dysregulation of the expression of cytokines and cytokine receptors, and there are some reports of genetic predispositions, based on single nucleotide polymorphisms, to cART-related lipoatrophy [6,[9][10][11][12]. We showed in a previous study that there is no association between changes in leptin levels and the development of lipoatrophy [13]. In this study, we evaluated the association between sex hormone levels and the development of lipoatrophy in HIV-infected men treated with cART. Materials and methodsThe Swiss HIV Cohort Study (SHCS; www.shcs.ch) prospectively follows HIV-infected adults. Every 6 months, clinical data are collected and blood plasma samples are drawn, analysed and stored at À 80 1C for future research. Study designWe performed a nested case-control study in HIV-infected, antiretroviral therapy-naïve Caucasian men who were successfully treated with zidovudine (ZDV)-and lamivudine (3TC)-based cART for a minimum of 2 years. Patients with acute opportunistic infections, uncontrolled AIDSdefining illnesses, diabetes mellitus, androgen treatment or a change in cART during the study period were excluded. Cases developing lipoatrophy and negative controls were identified and serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), free testoste...

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“…But the role of estradiol in HIV sexual dysfunctions is not clear. The expected decrease in blood of the gonadotropin hormones was not confirmed (Collazos et al 2002a), and one study observed improving on sexual function despite higher blood levels of estradiol (Collazos et al 2002b). On the other side, an study on rabbits found estrogen receptors in cavernous body, and found pathophysiological changes in erectile function when rabbits are under continuous estrogen intake (Srilatha and Adaikan 2004).…”

Section: Hormonal Factorsmentioning

confidence: 99%

Sexual Dysfunctions

Scanavino¹

2011

HIV and AIDS - Updates on Biology, Immunology, Epidemiology and Treatment Strategies

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Sexual hormones in HIV-infected patients: the influence of antiretroviral therapy

Cited by 41 publications

References 9 publications

HIV Treatment Adherence and Sexual Functioning

HIV Treatment Adherence and Sexual Functioning

Androgen and gonadotropin patterns differ in HIV‐1‐infected men who develop lipoatrophy during antiretroviral therapy: a case–control study

Sexual Dysfunctions

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