在感染HIV-1的男性中，性腺功能减退很常见，且在抗逆转录病毒治疗期间不会缓解。
Hypogonadism in HIV-1-infected men is common and does not resolve during antiretroviral therapy.
作者信息
Wunder Dorothea M, Bersinger Nick A, Fux Christoph A, Mueller Nicolas J, Hirschel Bernard, Cavassini Matthias, Elzi Luigia, Schmid Patrick, Bernasconi Enos, Mueller Bruno, Furrer Hansjakob
机构信息
Department of Obstetrics and Gynaecology, University Hospital of Berne, Berne, Switzerland.
出版信息
Antivir Ther. 2007;12(2):261-5.
OBJECTIVES
To assess the prevalence of abnormal testosterone and gonadotropin values in HIV-infected men before and after 2 years of combination antiretroviral therapy (cART).
DESIGN
Multicentre cohort of HIV-infected adults.
METHODS
We identified 139 Caucasian antiretroviral-naive male patients who started zidovudine/ lamivudine-based cART that was virologically successful over a 2 year period. Ninety-seven were randomly chosen and plasma hormone determinations of free testosterone (fT) and luteinizing hormone (LH) at baseline and after 2 years of cART were evaluated.
RESULTS
At baseline 68 patients (70%) had subnormal fT levels. In these, LH levels were low in 44%, normal in 47% and high in 9%. There was a trend for an association between lower CD4+ T-cell counts and hypogonadism. Most participants had normal FSH levels. No significant changes of fT, LH and FSH levels were observed after 2 years of cART.
CONCLUSIONS
Low fT levels, mainly with normal or low LH levels and thus indicating secondary hypogonadism, are found in the majority of HIV-infected men and do not resolve during 2 years of successful cART.
目的
评估接受联合抗逆转录病毒治疗（cART）2年前后，HIV感染男性体内睾酮和促性腺激素值异常的发生率。
设计
HIV感染成人多中心队列研究。
方法
我们纳入了139名未接受过抗逆转录病毒治疗的白人男性患者，他们开始接受以齐多夫定/拉米夫定为基础的cART治疗，并在2年期间病毒学治疗成功。随机选取97名患者，评估其基线时以及cART治疗2年后血浆中游离睾酮（fT）和促黄体生成素（LH）的激素测定结果。
结果
基线时，68名患者（70%）的fT水平低于正常。其中，LH水平低者占44%，正常者占47%，高者占9%。CD4 + T细胞计数较低与性腺功能减退之间存在关联趋势。大多数参与者的促卵泡生成素（FSH）水平正常。cART治疗2年后，未观察到fT、LH和FSH水平有显著变化。
结论
大多数HIV感染男性存在低fT水平，主要表现为LH水平正常或偏低，提示继发性性腺功能减退，且在2年成功的cART治疗期间未得到缓解。
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