Department of Medicine, Unit of Endocrinology and Metabolism, L'Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia, Italy.
Endocrinology, Montichiari Hospital, L'Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia, Italy.
Lancet HIV. 2020 Nov;7(11):e782-e790. doi: 10.1016/S2352-3018(20)30236-8.
The advent of new classes of antiretroviral drugs has improved the survival of people with HIV, and several ageing-related conditions, including hypogonadism and osteoporosis, have emerged. However, both are silent conditions, and are underestimated, underdiagnosed, and not adequately treated. Several factors, including the effects of the virus, antiretroviral therapy, lifestyle factors, and comorbidities, contribute to testicular dysfunction, which in turn has important effects on bone health. The prevalence of hypogonadism is approximately 20% among men with HIV, but extreme variability in the laboratory and clinical assessment of hypogonadism is reported. The prevalence of osteoporosis is 10-30%, but the poor quality of most studies does not allow definitive conclusions on clinical management. Nonetheless, the early and detailed evaluation of gonadal function and bone health is crucial for improving the quality of life of men with HIV.
新型抗逆转录病毒药物的出现改善了艾滋病毒感染者的生存率，一些与衰老相关的疾病，包括性腺功能减退症和骨质疏松症，也随之出现。然而，这两种疾病都是悄无声息的，往往被低估、漏诊，而且治疗也不充分。多种因素，包括病毒的影响、抗逆转录病毒治疗、生活方式因素和合并症，都会导致睾丸功能障碍，而睾丸功能障碍反过来又会对骨骼健康产生重要影响。大约 20%的 HIV 男性患者存在性腺功能减退症，但在性腺功能减退症的实验室和临床评估中，存在着极大的变异性。骨质疏松症的患病率为 10-30%，但大多数研究的质量较差，无法对临床管理得出明确结论。尽管如此，早期和详细评估性腺功能和骨骼健康对于提高 HIV 男性的生活质量至关重要。
