Human Immunodeficiency Virus Infection
and Male Hypogonadism: A Review
Noppadol Kietsiriroje MD*
Affiliation :
* Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine,
Prince of Songkla University, Songkhla, Thailand
Hypogonadism is a common complication among HIV infected patients. The prevalence of hypogonadism is
30 to 50% in HIV infected men with wasting syndrome and 20 to 25% in those without wasting syndrome. HIV infection
affects the entire hypothalamus-pituitary-gonadal axis via both direct and indirect effects, which are defined in four categories,
1) direct effect of HIV particles, 2) opportunistic infections, 3) HIV-related malignancy and its treatment, and 4) medications
that are used for HIV infection or its opportunistic infection. The association between HIV infection, hypogonadism, and
cardiovascular diseases has yet to be determined; however, there are data that HIV infection and its treatment, particularly
protease inhibitors, worsened the metabolic profiles, which were surrogate markers of cardiovascular diseases. Considerably
more attention should be paid to the diagnosis of hypogonadism in this group particularly because HIV infection increases
both sex hormone-binding globulin and total testosterone level. Testosterone replacement shows benefits on mood, body
composition, and seems to benefit the metabolic profile in HIV infected men with low body mass index.
Keywords : HIV, Male, Hypogonadism, Testosterone, Deficiency
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