Hypogonadism in the HIV-infected man

Endocrinol Metab Clin North Am. 2014 Sep;43(3):709-30. doi: 10.1016/j.ecl.2014.06.005.

Abstract

Androgen deficiency occurs frequently in men with human immunodeficiency virus (HIV) infection. Antiretroviral treatments had reduced the prevalence of male hypogonadism. The pathogenesis of testosterone (T) deficiency in HIV is multifactorial. Several mechanisms have been proposed; among them, drugs, fat redistribution, and a poor health status could explain the mechanism leading to gonadotropins inhibition and hypogonadotropic hypogonadism. The diagnosis of hypogonadism in HIV-infected men should be made based on clinical symptoms and a specific workup including T measurement. The interpretation of the results of biochemical testing is more difficult in men with HIV due to several confounding factors. T treatment should be offered to HIV-infected men with documented clinical hypogonadism and symptoms, especially if they are losing lean mass.

Keywords: Androgen deficiency; Antiretroviral therapy; Gonadotropins; Health status; LH; Premature aging; SHBG; Testosterone.

Publication types

  • Review

MeSH terms

  • Antiretroviral Therapy, Highly Active / statistics & numerical data
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology
  • HIV-1 / physiology
  • Hormone Replacement Therapy / statistics & numerical data
  • Humans
  • Hypogonadism / diagnosis
  • Hypogonadism / epidemiology
  • Hypogonadism / etiology*
  • Male
  • Risk Factors
  • Testosterone / analysis
  • Testosterone / blood
  • Testosterone / therapeutic use

Substances

  • Testosterone