Prevalence and Risk Factors for Hypogonadism in HIV-Infected Men

SANDRA Y. CHUNG, MD, NEIL A. ACCORTT, PhD, JAMES L. RAPER, ScD, JEROAN ALLISON, MD, RAY Y. CHEN, MD, and MICHAEL S. SAAG, MD,

Author address: 

Univ. of Alabama at Birmingham, Birmingham, AL

Abstract: 

Background: Hypogonadism among HIV-infected men is common yet poorly understood. Past studies indicate a prevalence of 15-50% in selected populations. We examined the prevalence, demographic characteristics, and clinical correlates of hypogonadism in an outpatient population of HIV-infected men. Methods: Patients were drawn from an ongoing, observational database at the UAB HIV clinic. Men with baseline visits between 1/1/96-8/31/02, 1 follow-up visits, and 18 years of age were included. Cases were defined by diagnosis of hypogonadism, use of testosterone replacement, or laboratorydemonstrated low free testosterone. All other patients were designated as noncases. Cases were followed until date of diagnosis while non-cases were followed until date of last follow-up or endpoint (8/31/02). Factors associated with disease were determined by Cox proportional hazard modeling. Results: 114 cases and 875 non-cases were identified. Prevalence11.5%. Compared to non-cases, cases were predominantly Caucasian (69.3% vs. 53.1%, p0.001), had lower median nadir CD4 count (75 vs. 178/l, p0.0001), and higher median peak viral load (95,757 vs. 53,723/ml, p0.0006). Median age and HAART use were similar. The final multivariable model is shown. Insignificant factors (p0.1) included age, fatigue, weight loss, depression, medications other than megestrol (antifungals, steroids), hyperlipidemia, diabetes, and opportunistic infections. Conclusion: Hypogonadism occurred in over 10% of our outpatient population of HIV-infected men. Caucasian men with erectile dysfunction, nadir CD4 count 200/l, cancer, megestrol use, and a shorter duration of HAART use were at highest risk. In subjects without erectile dysfunction, the other risk factors were still significant. Our data suggest that HIV-infected men without typical complaints of hypogonadism (fatigue, weight loss, depression) should be screened more aggressively
2003

abstract No: 

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Full conference title: 

41st Annual Meeting Infectious Diseases Society of America
    • Infectious Diseases Society of America 41st