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Hypogonadism in HIV-infected males

Morris Schambelan, MD
Melissa Weinberg, MD
Section Editor
John G Bartlett, MD
Deputy Editor
Howard Libman, MD, FACP


Hypogonadism was recognized early in the HIV epidemic as being relatively common. Low serum testosterone levels in HIV-infected men may be associated with a variety of manifestations including fatigue, decreased libido and erectile dysfunction, weight loss, muscle wasting, and bone loss [1].

Hypogonadism in a male refers to a decrease in one or both of the two major functions of the testes: sperm production and testosterone production. These abnormalities can result from disease of the testes (primary hypogonadism) or malfunction of the hypothalamus or pituitary gland (secondary hypogonadism). (See 'Determining the etiology' below.)

This topic addresses hypogonadism in HIV-infected men. General information about male hypogonadism is discussed elsewhere. (See "Clinical features and diagnosis of male hypogonadism" and "Testosterone treatment of male hypogonadism".)


The prevalence of hypogonadism in HIV-infected men has been observed to be lower since the advent of potent antiretroviral therapy (ART) and its earlier initiation in care.

Earlier studies of endocrine dysfunction among HIV-infected patients showed that 30 to 50 percent of symptomatic men had low total testosterone levels, often in association with weight loss and CD4 lymphocyte depletion, and that this finding was much more common than abnormalities in thyroid or adrenal function [2-5].

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Literature review current through: Nov 2017. | This topic last updated: Nov 30, 2017.
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