Introduction: Male hypogonadism is very frequent in men treated with highly active anti-retroviral therapy (HAART) for Human Immunodeficiency Virus-1 (HIV-1) infection, reaching a prevalence of about 20%. Literature data regarding the time course of serum total testosterone (T) levels in these patients are lacking.
Aim of the study: To evaluate changes of T levels over time in HIV-positive men with an initial finding of low T (<300 ng/dl).
Methods: Measurement of T and serum LH in 111 hypogonadic HIV positive outpatients aged 3168 years (mean 46.3 years) at baseline and after 12 months.
Results: Mean T value at baseline was 235.8 ng/dl. After 12 months, 36 subjects (32.4%) had no change in T (a variation of <50 ng/ml), 3 patients (2.7%) had a decrease (more than 50 ng/ml) and 72 patients (64.9%) had an increase in T (more than 50 ng/ml). 63 patients (56.7%) normalized T (>300 ng/ml). Mean T value at baseline of the 63 patients who restored T was 236.3±66.9 ng/ml, while mean T value at baseline of the 9 patients who didnt normalize was 151.4±86.5 ng/ml.
Conclusions: Most of the HIV patients under HAART with an initial finding of low T present normalized T in the following months. Baseline T values seem to be predictive of the future evolution of the disease, higher T level being associated with subsequent T normalization. In HIV patients a single finding of hypotestosteronemia needs further confirmation before starting androgen therapy and often a wait-and-see approach is mandatory.
30 Apr - 04 May 2011
European Society of Endocrinology