来曲唑与睾酮对比：一项针对接受高效抗逆转录病毒疗法（HAART）且患有性欲减退障碍和雌二醇水平升高的男男性行为艾滋病毒感染者的单中心试点研究。

Letrozole versus testosterone. a single-center pilot study of HIV-infected men who have sex with men on highly active anti-retroviral therapy (HAART) with hypoactive sexual desire disorder and raised estradiol levels.

作者信息

Richardson Daniel, Goldmeier David, Frize Graham, Lamba Harpal, De Souza Carl, Kocsis Agnes, Scullard George

机构信息

St. Mary's Hospital-Jefferiss Wing, London, UK.

出版信息

J Sex Med. 2007 Mar;4(2):502-8. doi: 10.1111/j.1743-6109.2007.00451.x.

DOI:10.1111/j.1743-6109.2007.00451.x

PMID:17367446

Abstract

INTRODUCTION

Since the advent of Highly Active Anti-Retroviral Therapy (HAART), men with HIV experience good quality of life and expect to have normal sexual function. However, it appears that men infected with HIV commonly complain of sexual problems. There is evidence that men on HAART develop low sexual desire that is associated with raised estradiol levels. It has been postulated that abnormal metabolism seen in this group of men increases the aromatization of testosterone to estradiol. We hypothesized that letrozole, an aromatase inhibitor that inhibits the conversion of testosterone to estradiol, would be beneficial in these men.

AIM

The aim of this study was to compare the effects of testosterone vs. an aromatase inhibitor, letrazole, in HIV-infected men with raised estradiol and low sexual desire.

METHODS

Thirteen men who have sex with men on HAART with low sexual desire as well as raised estradiol levels (>120 pmol/L) were randomly allocated to receive either parenteral testosterone (Sustanon 250 intramuscular injection) (N = 6) or letrozole 2.5 mg orally daily (N = 7) for 6 weeks.

MAIN OUTCOME MEASURES

Sex steroid hormone assays, sex hormone-binding globulin, virological, hematological, and biochemical parameters were measured before and after treatment. Each subject was given the Spector Sexual Desire Inventory and the Depression/Anxiety Stress Scale before and immediately after treatment. Subjects were also asked to estimate the number of actual sexual acts before and after treatment. Results. Inventory data showed a rise in dyadic desire in both treatment arms. Mean actual sexual acts rose from 0.33 to 1.5 in the testosterone group and from 0.43 to 1.29 for the letrozole group. Luteinizing hormone increased in seven of seven men on letrozole. Serum testosterone increased in seven of seven men on letrozole. There were no adverse events from either medication.

CONCLUSION

Letrozole may be useful in the management of men on HAART who have low sexual desire.

摘要

引言

自从高效抗逆转录病毒疗法（HAART）问世以来，感染艾滋病毒的男性生活质量良好，并期望拥有正常的性功能。然而，感染艾滋病毒的男性似乎普遍抱怨存在性问题。有证据表明，接受HAART治疗的男性会出现性欲低下，这与雌二醇水平升高有关。据推测，这群男性中出现的异常代谢会增加睾酮向雌二醇的芳香化。我们假设，来曲唑，一种抑制睾酮转化为雌二醇的芳香化酶抑制剂，对这些男性有益。

目的

本研究的目的是比较睾酮与芳香化酶抑制剂来曲唑对雌二醇升高且性欲低下的艾滋病毒感染男性的影响。

方法

13名接受HAART治疗、性欲低下且雌二醇水平升高（>120 pmol/L）的男男性行为者被随机分配接受肌肉注射睾酮（长效睾酮250）（N = 6）或每日口服来曲唑2.5毫克（N = 7），为期6周。

主要观察指标

在治疗前后测量性甾体激素测定、性激素结合球蛋白、病毒学、血液学和生化参数。在治疗前和治疗后立即对每个受试者进行斯佩克特性欲量表和抑郁/焦虑压力量表评估。还要求受试者估计治疗前后实际性行为的次数。结果。量表数据显示两个治疗组的双性欲望均有所增加。睾酮组的平均实际性行为次数从0.33次增加到1.5次，来曲唑组从0.43次增加到1.29次。接受来曲唑治疗的7名男性中有7名促黄体生成素升高。接受来曲唑治疗的7名男性中有7名血清睾酮升高。两种药物均未出现不良事件。