Muthiah Bhanukumar, Kallikadavil Abithraj, Shivaswamy Rajendraprasad, Menon Vineetha Bharathan
Associate Professor, Department of General Medicine, JSS Medical College and Hospital , SS Nagar, Mysore, Karnataka, India .
Post Graduate, Department of General Medicine, JSS Medical College and Hospital , SS Nagar, Mysore, Karnataka, India .
J Clin Diagn Res. 2016 Apr;10(4):OC11-4. doi: 10.7860/JCDR/2016/18992.7581. Epub 2016 Apr 1.
Every endocrine gland has been reported to be affected at varying rates in HIV. HIV is a highly stigmatized chronic disease with a substantial co-occurrence of mental and sexual health problems; however the sexual health problems in women have not been extensively studied.
To study the gonadal hormonal abnormalities and sexual dysfunction in HIV positive female patients and its possible association.
This descriptive/exploratory study was conducted in the Department of General Medicine at a tertiary care hospital from September 2013 to August 2015. The study group included 50 diagnosed HIV-positive patients. They were also subjected to specific questions regarding sexual dysfunction by female counselors using female sexual function index. Visits of the subjects were scheduled independent of the menstrual cycle. Hormonal levels (free testosterone, FSH, LH) were measured.
Out of 50 patients, 26 patients in our study had sexual dysfunction (52%). Patients with age group between 30-39 years had the maximum sexual dysfunction compared to the other groups (<0.001). Patients with a CD4 count between 200 and 499 had the maximum sexual dysfunction (<0.02). Mean duration of HIV in the study was 30 months in sexual dysfunction group which was significant (p<0.005). Hormonal levels were found to be in normal range. All the study patients reported desire, arousal and lubrication problems whereas orgasm and satisfaction problems were noted in 60% patients with pain reported in 52%.
We identified that although the hormonal levels were in the normal range, they were comparatively in the lower range in the dysfunction group than the non-dysfunctional group. Both free testosterone and FSH levels were low indicating involvement of the pituitary rather than the gonads. We also conclude that duration of HIV and also level of CD4 count is related to sexual dysfunction.
据报道，在感染艾滋病毒的情况下，每个内分泌腺受影响的速率各不相同。艾滋病毒是一种饱受污名的慢性疾病，常伴有大量精神和性健康问题；然而，女性的性健康问题尚未得到广泛研究。
研究艾滋病毒阳性女性患者的性腺激素异常和性功能障碍及其可能的关联。
这项描述性/探索性研究于2013年9月至2015年8月在一家三级护理医院的普通内科进行。研究组包括50名确诊的艾滋病毒阳性患者。女性咨询师使用女性性功能指数对她们进行了关于性功能障碍的特定问题询问。受试者的就诊安排与月经周期无关。测量了激素水平（游离睾酮、促卵泡激素、促黄体生成素）。
在50名患者中，我们研究中有26名患者存在性功能障碍（52%）。与其他组相比，年龄在30 - 39岁之间的患者性功能障碍最为严重（<0.001）。CD4细胞计数在200至499之间的患者性功能障碍最为严重（<0.02）。性功能障碍组中艾滋病毒感染的平均持续时间为30个月，具有显著性（p<0.005）。发现激素水平在正常范围内。所有研究患者均报告有性欲、性唤起和润滑问题，而60%的患者存在性高潮和满意度问题，52%的患者报告有疼痛问题。
我们发现，尽管激素水平在正常范围内，但功能障碍组的激素水平相较于无功能障碍组相对较低。游离睾酮和促卵泡激素水平均较低，表明垂体而非性腺受到影响。我们还得出结论，艾滋病毒感染的持续时间以及CD4细胞计数水平与性功能障碍有关。
