Metabolic Clinic, Infectious Diseases Unit, Department of Medicine and Medical Specialities, University of Modena and Reggio Emilia, Modena, Italy.
J Sex Med. 2012 Jul;9(7):1923-30. doi: 10.1111/j.1743-6109.2012.02750.x. Epub 2012 Apr 30.
Erectile dysfunction (ED) is common among elderly men and patients suffering from chronic diseases, the latter probably including also HIV infection. No studies, however, compared the prevalence of ED in HIV-infected and HIV-uninfected individuals using the international index of erectile function (IIEF-15).
The aim of this study is to compare ED prevalence in young to middle-aged men with and without HIV infection using the IIEF-15 questionnaire.
We conducted a cross-sectional, observational, controlled study on 444 HIV-infected men and 71 HIV-uninfected men.
The IIEF-15 questionnaire was used to assess ED. A cutoff score of ≤25 of the erectile domain was used to diagnose ED. Serum testosterone, demographic, and anthropometric (weight, height, and body mass index [BMI]) characteristics were obtained from all participants. Statistics included the T-test, the Fisher's test, univariable and multivariable logistic regression, and univariate and multivariate Spearman's correlation analysis.
The HIV-uninfected group was significantly younger than the HIV-infected group and presented a higher BMI (P < 0.001). The prevalence of mild, moderate, and severe ED was higher in HIV-infected men than in HIV-uninfected men of all decades of age. In univariate analysis, HIV infection was associated with ED (odds ratio [OR] = 34.19, P < 0.001). In multivariable logistic regression analysis, HIV infection remained the strongest predictors of ED (OR = 42.26, P < 0.001) followed by hypogonadism, after adjusting for age and BMI.
This study demonstrates a clear association between ED and HIV infection, after adjusting for age and BMI. Other than HIV infection, hypogonadism was associated with ED. In addition, the prevalence of ED was higher in HIV-infected men than in HIV-uninfected men, in all decades of age. The early onset of ED in HIV-infected men could be considered a peculiar clinical hallmark of HIV and confirms precocious aging in these patients. ED should be of concern to clinicians when managing HIV-infected men even if the latter are young or middle aged.
勃起功能障碍（ED）在老年男性和患有慢性病的患者中很常见，后者可能也包括 HIV 感染。然而，尚无研究使用国际勃起功能指数（IIEF-15）比较 HIV 感染者和 HIV 未感染者中 ED 的患病率。
本研究旨在使用 IIEF-15 问卷比较年轻到中年 HIV 感染者和非 HIV 感染者中 ED 的患病率。
我们对 444 名 HIV 感染者和 71 名 HIV 未感染者进行了横断面、观察性、对照研究。
使用 IIEF-15 问卷评估 ED。勃起功能域的得分≤25 用于诊断 ED。所有参与者均获得血清睾酮、人口统计学和人体测量学（体重、身高和体重指数 [BMI]）特征。统计学方法包括 T 检验、Fisher 检验、单变量和多变量逻辑回归以及单变量和多变量 Spearman 相关分析。
HIV 未感染者组明显比 HIV 感染者组年轻，且 BMI 较高（P < 0.001）。与 HIV 未感染者相比，所有年龄段的 HIV 感染者中轻度、中度和重度 ED 的患病率更高。在单变量分析中，HIV 感染与 ED 相关（优势比 [OR] = 34.19，P < 0.001）。在多变量逻辑回归分析中，调整年龄和 BMI 后，HIV 感染仍然是 ED 的最强预测因素（OR = 42.26，P < 0.001）。其次是性腺功能减退症。
本研究表明，在调整年龄和 BMI 后，ED 与 HIV 感染之间存在明确关联。除 HIV 感染外，性腺功能减退症与 ED 相关。此外，与 HIV 未感染者相比，所有年龄段的 HIV 感染者中 ED 的患病率更高。HIV 感染者中 ED 的早期发病可被视为 HIV 的一种特殊临床特征，并证实这些患者提前衰老。即使 HIV 感染者为年轻或中年男性，ED 也应引起临床医生的关注。
