Hypogonadism in HIV-infected males
- Morris Schambelan, MD
Morris Schambelan, MD
- Professor Emeritus of Medicine
- University of California San Francisco
- Melissa Weinberg, MD
Melissa Weinberg, MD
- Assistant Clinical Professor of Medicine
- University of California, San Francisco
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 .
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].To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- RISK FACTORS
- Age and comorbidities
- Obesity and insulin resistance
- HIV-specific factors
- Antiretroviral therapy
- Other medications/substances
- Liver disease
- CLINICAL MANIFESTATIONS
- Establishing the diagnosis
- - Checking testosterone level
- - Interpretation of testosterone levels
- Determining the etiology
- Assessment for other contributing factors
- TESTOSTERONE REPLACEMENT THERAPY
- Pretreatment evaluation
- Duration of treatment
- Adverse events
- Contraindications and cautions
- Monitoring patients
- SOCIETY GUIDELINE LINKS
- SUMMARY AND RECOMMENDATIONS