Rietschel P, Corcoran C, Stanley T, Basgoz N, Klibanski A, Grinspoon S
Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Clin Infect Dis. 2000 Nov;31(5):1240-4. doi: 10.1086/317457. Epub 2000 Nov 2.
Previous studies have indicated that there is a significant prevalence (50%) of hypogonadism among men with acquired immunodeficiency syndrome (AIDS)-associated wasting, and for these patients testosterone administration has been shown to increase lean body mass and improve quality of life. However, the prevalence of hypogonadism is not known among men with weight loss related to human immunodeficiency virus (HIV) infection who are receiving highly active antiretroviral therapy (HAART). From 1997 through 1999, we investigated total and free testosterone levels in 90 men who were <90% of ideal body weight or had weight loss of >10% from preillness weight; 71% of these subjects were receiving HAART. Twenty-one percent of the subjects receiving HAART had low free testosterone levels. No correlation was seen between weight, CD4 cell count, medication status, and other clinical factors. These data suggest that hypogonadism remains relatively common in men with AIDS wasting, despite treatment with HAART. HIV-infected men with wasting syndrome should be screened for hypogonadism and receive physiological androgen replacement therapy if they are hypogonadal.
既往研究表明，在患有获得性免疫缺陷综合征（AIDS）相关消瘦的男性中，性腺功能减退的患病率很高（50%），并且对于这些患者，已证明给予睾酮可增加瘦体重并改善生活质量。然而，在接受高效抗逆转录病毒治疗（HAART）的与人类免疫缺陷病毒（HIV）感染相关的体重减轻男性中，性腺功能减退的患病率尚不清楚。从1997年到1999年，我们调查了90名体重低于理想体重的90%或比患病前体重减轻超过10%的男性的总睾酮和游离睾酮水平；这些受试者中有71%正在接受HAART治疗。接受HAART治疗的受试者中有21%的游离睾酮水平较低。体重、CD4细胞计数、用药情况和其他临床因素之间未发现相关性。这些数据表明，尽管接受了HAART治疗，但性腺功能减退在患有AIDS消瘦的男性中仍然相对常见。患有消瘦综合征的HIV感染男性应接受性腺功能减退筛查，如果性腺功能减退则应接受生理性雄激素替代治疗。
