Testosterone treatment of clinical hypogonadism in patients with HIV/AIDS

Rabkin, Judith G.; Rabkin, Richard; Wagner, Glenn

doi:10.1258/0956462971920703

Cited by 42 publications

(24 citation statements)

References 23 publications

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“…49,50 One study suggested that testosterone may also slow or halt the progression from metabolic syndrome to diabetes or cardiovascular disease. 51 Patients who initiate therapy should be monitored closely, especially in regards to testosteronedependent diseases such as prostate cancer.…”

Section: Discussionmentioning

confidence: 99%

Erectile Dysfunction and Hypogonadism among Men with HIV

Crum-Cianflone

Bavaro

Hale

et al. 2007

AIDS Patient Care and STDs

111

135

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Erectile dysfunction (ED) and hypogonadism are increasingly recognized conditions, however, the prevalence and etiologies of these conditions among HIV-infected men remain unclear. We studied 300 HIV-infected men who completed standardized questionnaires regarding sexual function and hypogonadal symptoms. An early morning testosterone test was performed; patients with a low serum testosterone level (defined by <300 ng/dL), underwent additional blood tests to determine the etiology of the hypogonadism. The participants' mean age was 39 years (range, 19-72); 61% were Caucasian; 24%, African American; 9%, Hispanic; and 5% other. Participants had been HIV-positive for a mean of 9 years (range, 0.5-20) with a mean CD4 count of 522 cells/mm(3) (range, 1-1531). Sixty percent were receiving antiretroviral therapy. ED was reported by 61.4%; of those with ED, 32% did not have a rigid enough erection for penetration, and 46% were unable to sustain an erection for the completion of intercourse. In the multivariate analysis, increasing age (odds ratio [OR] 1.4 for a 5-year increment, p < 0.001) and depression (OR 2.64, p < 0.0001) were associated with ED. A higher current CD4 count was protective (OR 0.80 for each 100 cells/mm(3), p = 0.004). Only 25% of patients with ED had utilized a phosphodiesterase-5-inhibitor for treatment. Seventeen percent of the 300 men were hypogonadal; there was no correlation between hypogonadism and ED. Increasing age and a higher body mass index (BMI) were positively associated with hypogonadism, while smoking was negatively associated (OR 0.44, p = 0.02). All patients with low testosterone had secondary hypogonadism. There was no association between ED or hypogonadism with the current, past, or cumulative use of HIV medications.

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Section: Discussionmentioning

confidence: 99%

Erectile Dysfunction and Hypogonadism among Men with HIV

Crum-Cianflone

Bavaro

Hale

et al. 2007

AIDS Patient Care and STDs

111

135

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“…The risks of medically prescribed and supervised testosterone are fairly well characterized in both medically healthy patients 4 and those with HIV infection (see Rabkin et al 29 for a review of the latter literature). The most serious risk concerns exacerbation (but not causation) of prostate cancer.…”

Section: Commentmentioning

confidence: 99%

A Double-blind, Placebo-Controlled Trial of Testosterone Therapy for HIV-Positive Men With Hypogonadal Symptoms

Rabkin

Wagner²,

Rabkin³

2000

Arch Gen Psychiatry

Self Cite

187

106

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“…11 Other reported causes of hypogonadism in HIVinfected men include testicular dysfunction (interference with Leydig cell testosterone production by antibodies and cytokines), testicular disease (direct involvement of the testes by HIV, opportunistic infections or malignancies) and some drugs used to treat HIV-related complications notably megesterol and ketaconazole. [21][22][23][24][25][26] Testosterone replacement of men infected with HIV has been shown to improve both erectile dysfunction and low sexual desire. 26 In older studies, a low serum testosterone has been described in HIV-infected men, but to date the pathogenesis and mechanism of this is unclear.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with sexual dysfunction in men with HIV infection

et al. 2006

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Where men have had access to successful treatment for HIV (highly active antiretroviral therapy), expectations of both patients and physicians alike have changed significantly over the past decade. Such men, living with HIV, expect to lead fully functional lives including a normal sex life. Sexual dysfunction is well described among men with HIV. We retrospectively analysed details of 190 consecutive men attending a dedicated sexual dysfunction service in our HIV unit over an 18-month period. We took note of the specifics of their HIV disease, illnesses other than HIV, as well as other risk factors associated with sexual dysfunction. Men with sexual dysfunction all commonly reported recreational drug use, hepatitis B and C co-infection, anxiety and depressive illnesses, peripheral neuropathy and lipodystrophy. There was a significant relationship between men complaining of retarded ejaculation and peripheral neuropathy. Sexual dysfunction in non-HIV settings is known to lead to poor adherence to prescribed medications, e.g. antihypertensive agents. Iatrogenic sexual dysfunction in patients may similarly have a potential to lead to poor antiretroviral compliance if not addressed.

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Testosterone treatment of clinical hypogonadism in patients with HIV/AIDS

Cited by 42 publications

References 23 publications

Erectile Dysfunction and Hypogonadism among Men with HIV

Erectile Dysfunction and Hypogonadism among Men with HIV

A Double-blind, Placebo-Controlled Trial of Testosterone Therapy for HIV-Positive Men With Hypogonadal Symptoms

Factors associated with sexual dysfunction in men with HIV infection

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