Schrooten W, Colebunders R, Youle M, Molenberghs G, Dedes N, Koitz G, Finazzi R, de Mey I, Florence E, Dreezen C
Institute of Tropical Medicine, Department of Clinical Sciences, Antwerp, Belgium.
AIDS. 2001 May 25;15(8):1019-23. doi: 10.1097/00002030-200105250-00010.
A high proportion of individuals receiving highly active antiretroviral treatment (HAART) complain of sexual dysfunction (SD), encompassing a lack of desire or erectile dysfunction.
To determine whether SD was associated with particular components of the HAART regimens and to identify risk factors for the development of SD in patients on HAART.
A survey among patients with HIV infection using an anonymous questionnaire was conducted in 10 European countries between December 1998 and December 1999. A total of 904 individuals currently receiving antiretroviral agents were included in the analyses.
A decrease in sexual interest was significantly more frequently reported by subjects (men and women) using HAART containing protease inhibitors (PI) (308/766, 40%), compared with PI-naive patients (22/138, 16%; OR 3.55; 95% CI 2.15--5.89). In addition, a significantly larger number of PI-experienced men reported a decrease in sexual potency (216/628, 34%) compared with PI-naive men (12/99, 12%; OR 2.56; 95% CI 1.33--5.03). In multivariate analyses the following factors were associated with a decrease in sexual interest: a current PI-containing regimen, a history of a PI regimen, symptomatic HIV infection, age and homosexual contact as HIV transmission mode. Factors associated with a decrease in sexual potency were: current use of a PI-containing regimen, symptomatic HIV disease, age and the use of tranquillisers.
SD appears to be a common side-effect of HAART regimens containing a PI. The potential association between SD and other side-effects of HAART, such as lipodystrophy syndrome and neuropathy, should be investigated further.
接受高效抗逆转录病毒治疗（HAART）的患者中，很大一部分抱怨存在性功能障碍（SD），包括性欲缺乏或勃起功能障碍。
确定性功能障碍是否与HAART方案的特定组成部分相关，并识别接受HAART治疗患者发生性功能障碍的危险因素。
1998年12月至1999年12月期间，在10个欧洲国家对HIV感染患者进行了一项使用匿名问卷的调查。共有904名目前正在接受抗逆转录病毒药物治疗的个体纳入分析。
与未使用蛋白酶抑制剂（PI）的患者相比，使用含PI的HAART方案的受试者（男性和女性）报告性兴趣下降的频率显著更高（308/766，40%），而未使用PI的患者为（22/138，16%；比值比3.55；95%可信区间2.15 - 5.89）。此外，与未使用PI的男性相比，有PI使用经验的男性报告性功能下降的人数显著更多（216/628，34%），而未使用PI的男性为（12/99，12%；比值比2.56；95%可信区间1.33 - 5.03）。在多变量分析中，以下因素与性兴趣下降相关：当前含PI的治疗方案、PI治疗方案史、有症状的HIV感染、年龄以及作为HIV传播方式的同性恋接触。与性功能下降相关的因素有：当前使用含PI的治疗方案、有症状的HIV疾病、年龄以及使用镇静剂。
性功能障碍似乎是含PI的HAART方案的常见副作用。性功能障碍与HAART的其他副作用（如脂肪代谢障碍综合征和神经病变）之间的潜在关联应进一步研究。
