Background: Erectile dysfunction (ED) is an increasingly recognized condition among HIV-infected, however its prevalence and etiology remain unclear. Our aim was to asses prevalence and risk factors associated to ED in this population.
Methods: A cross-sectional study was performed, 88 male HIV-positive without hepatitis C or diabetes were studied. Patients were classified according antiretroviral treatment (ART): naïve, protease inhibitor (PI)-containing HAART and non-nucleoside (NN) containing HAART never exposed to PI. All patients completed standardized questionnaires regarding sexual function (IIEF-15, International Index of Erectile Function), and hypogonadal symptoms (Androgen Deficiency in Aging Men, ADAM; Aging Males Symptoms Scale, AMS). total testosterone (TT), sex hormone binding globulin (SHBG) and albumin tests were performed to calculate FT. ED was defined as IIEF-15≤25 and hypogonadism as FT<6.5 ng/dl. Univariate and multivariate logistic regression analyses were performed to asses risk factors associated to ED.
Results: Mean age 42 years (2568), 100% caucasian, mean time with HIV infection: 7.8±5.6 years, median CD4+ cells: 465 cells/mm3 (IQR, 365676), 84% received HAART. ED was diagnosed in 47/88 (53.4%) patients, according to ART, naive 10.6%, NN 42.6% and IP 46.8%. In univariate analyses, ED was associated with increasing age (odds ratio (OR) 1.07 for a 1-year increment, CI 1.011.14, P<0.02) and longer duration of PI therapy (OR 1.03 for a 1-month increment, CI 1.0051.05, P<0.02). In multivariate analysis, ED was associated with increasing age (OR 1.1, P=0.04) and longer duration of PI therapy (OR 1.04, P=0.01) too. Only 23% of patients with ED were treated with a phosphodiesterase-5-inhibitor, and it was effective in 81%. Hypogonadism was a risk factor for a moderate-severe ED (OR 4.2, P<0.05).
Conclusions: ED was associated with age and cumulative use of PI-containing HAART. Hypogonadism is a risk factor of ED in HIV infected men.
25 - 29 Apr 2009
European Society of Endocrinology