Department of Endocrinology and Nutrition, Hospital General Universitario de Alicante, Alicante, Spain.
AIDS. 2010 Jan 16;24(2):255-64. doi: 10.1097/QAD.0b013e328334444b.
To determine the prevalence of erectile dysfunction in a cohort of HIV-infected men in a stable clinical state, the effect of exposure to antiretroviral therapy on sexual dysfunction and to identify the risk factors.
This is a cross-sectional, observational study.
HIV-infected men without hepatitis C virus coinfection were included if they were antiretroviral therapy-naive (naive group), on current treatment with an enhanced protease inhibitor (protease inhibitor group) or on current treatment with two to three nucleoside reverse transcriptase inhibitors along with one nonnucleoside reverse transcriptase inhibitor and never having received treatment with protease inhibitor (nonnucleoside reverse transcriptase inhibitor group). Erectile dysfunction was defined as an ejection fraction of 25 or less (International Index of Erectile Function-15).
Ninety patients were included, with an age of 42 +/- 8.2 years and CD4 cell count of 465 cells/microl [P25-75 361-676]: 18.9% in Centers for Disease Control and Prevention class C and 72.2% with undetectable viral load. Seventy-six patients (84.4%) were receiving antiretroviral therapy, 39 (43.3%) in the protease inhibitor group. The prevalence of lipodystrophy was 31.5%. Forty-seven (53.4%) patients had an erectile dysfunction. Multivariate logistic regression analysis confirmed that there was an independent association between the patients' age (per decade; odds ratio 2.2, 95% confidence interval 1.04-4.5, P = 0.04) and greater duration of exposure to protease inhibitor (per year; odds ratio 1.6, 95% confidence interval 1.12-2.4, P = 0.01). Older age, depression and lipodystrophy, combined with the duration of exposure to protease inhibitor, determined a lower score on various sexual dysfunction domains (P < 0.05).
There is a high prevalence of erectile dysfunction in HIV-infected men, with age and the duration of exposure to protease inhibitor being the only identifiable risk factors.
确定稳定临床状态下 HIV 感染男性队列中勃起功能障碍的患病率，评估抗逆转录病毒治疗对性功能障碍的影响，并确定相关危险因素。
这是一项横断面、观察性研究。
纳入无丙型肝炎病毒合并感染的 HIV 感染男性，包括初治（初治组）、正在接受强化蛋白酶抑制剂治疗（蛋白酶抑制剂组）或正在接受两种至三种核苷类逆转录酶抑制剂联合一种非核苷类逆转录酶抑制剂治疗且从未接受过蛋白酶抑制剂治疗（非核苷类逆转录酶抑制剂组）。勃起功能障碍定义为射血分数<25%（国际勃起功能指数-15）。
共纳入 90 例患者，年龄 42±8.2 岁，CD4 细胞计数 465 个/μl[P25-75 361-676]：美国疾病控制与预防中心（CDC）分类 C 级 18.9%，病毒载量不可检测 72.2%。76 例（84.4%）患者正在接受抗逆转录病毒治疗，其中蛋白酶抑制剂组 39 例。脂代谢障碍的患病率为 31.5%。47 例（53.4%）患者存在勃起功能障碍。多变量逻辑回归分析证实，患者年龄（每 10 岁；优势比 2.2，95%置信区间 1.04-4.5，P=0.04）和接受蛋白酶抑制剂治疗的时间（每年；优势比 1.6，95%置信区间 1.12-2.4，P=0.01）是独立相关的。年龄较大、抑郁和脂代谢障碍与蛋白酶抑制剂治疗时间相结合，决定了各种性功能障碍领域的评分较低（P<0.05）。
HIV 感染男性勃起功能障碍的患病率较高，年龄和接受蛋白酶抑制剂治疗的时间是唯一可识别的危险因素。
