Prevalence and characterization of hypogonadism among men with human immunodeficiency virus infection: preliminary results
Vincenzo Rochira1, Giulia Brigante1, Daniele Santi1, Lucia Zirilli1, Chiara Diazzi1, Gabriella Orlando2, Cesare Carani1 & Giovanni Guaraldi2
Introduction: Among various comorbidities of human immunodeficiency virus-1 (HIV-1) infection, male hypogonadism is very frequent with a prevalence of 19% in patients treated with highly active anti-retroviral therapy. However, literature data are still lacking and achieved by studies with <300 subjects each.
Aim of the study: Prevalence and clinical characterization of hypogonadism among a large number of men with HIV-1.
Methods: Measurement of serum total testosterone, LH and FSH in 950 outpatients aged 2069 years (mean age 45.5 years) attending the metabolic clinic of infectious and tropical disease between 2005 and 2009.
Results: Mean serum total testosterone was 470.9±205.5 ng/dl. Considering Endocrine Society thresholds for hypogonadism, 15.7% of patients was hypogonadic (T<300 ng/dl); (8% hypogonadotropic, 77.2% normogonadotropic and 14.8% hypergonadotropic). According to thresholds proposed by the International Society for the Study of the Aging Male (ISSAM) 23.7% of subjects resulted hypogonadic (T<346 ng/dl) of which 5.8% was hypogonadotropic, 80% normogonadotropic and 14.2% hypergonadotropic.
|Endocrine Society ( T<300 ng/dl)||ISSAM (T<346 ng/dl)|
|Percentage of hypogonadism (n hypogonadic/n total)||15.7% (149/950)||23.7% (225/950)|
|LH<1.4 mUI/ml||8% (12/149)||5.8% (13/225)|
|1.4<LH<8.9 mUI/ml||77.2% (115/149)||80% (180/225)|
|LH>8.9 mUI/ml||14.8% (22/149)||14.2% (32/225)|
Conclusions: The prevalence of hypogonadism in HIV patients is comparable to that of older healthy subjects (19.3% of hypogonadism in patients with mean age 58.7 years; Schneider, Clin Endocrinol 2009) and is higher than in the general population. Normogonadotropism predominance in subjects with hypotestosteronemia suggests also a possible involvement of a pituitary dysfunction and/or dysregulation as the underlying cause responsible for the development of hypogonadism.