Author:
Iddi Shabani,Dika Haruna,Kidenya Benson R.,Kalluvya Samuel
Abstract
Abstract
Background
Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is an endemic chronic disease which is characterized with progressive depletion of CD4 T cells and increased susceptibility to opportunistic infections. Previous studies have associated HIV infection with increased hypogonadism. However, the prevalence of hypogonadism remained poorly defined and widely ranging in various studies. This study aims to evaluate the serum gonadal hormonal levels and hypogonadism in antiretroviral therapy (ART) naïve newly diagnosed HIV infected-males in Mwanza, Tanzania.
Methods
This was a comparison study involving 81 ART naïve newly diagnosed HIV-infected adult males as study group and 81 apparently healthy HIV-negative males as comparison group. The participants in the study group and comparison group were matched by body mass index and age. Serum hormones [Total testosterone (TT), follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E) were estimated. Serum testosterone < 300 ng/dl, or testosterone > 300 ng/dl with high LH and FSH (compensatory hypogonadism) were taken as markers of hypogonadism. Data were analyzed using STATA version 15.
Results
The median serum testosterone level among ART naïve newly diagnosed HIV-infected adult males was significantly lower as compared to their comparison group (447 [259–534] versus 517 [396–605]; p = 0.0074) and shown to decrease with decreasing CD4 level. The median [IQR] serum FSH level among ART naïve newly diagnosed HIV-infected adult males was significantly higher than among their comparison group (3.8 [2.1–6.5] versus 2.6 [1.8–4.2]; p = 0.0086). The differences in serum LH and Estradiol were not statistically significant. Furthermore, the proportion of hypogonadism was significantly higher among ART naïve newly diagnosed HIV-infected adult males than in their comparison group (37.0% [30/81] versus 14.8% [12/81]; p = 0.0006). Out of these 30, 24 HIV-infected males had secondary hypogonadism, one had primary, and the remaining five had compensatory hypogonadism.
Conclusion
Serum testosterone was lower and follicle stimulating hormone was higher among ART naïve HIV-infected males as compared to the HIV negative controls. Hypogonadism, mainly secondary, is common endocrine abnormality among ART naïve HIV-infected male patients in this study. HIV is associated with variations in gonadal hormones which may lead to sexual dysfunction in infected individuals.
Publisher
Springer Science and Business Media LLC
Reference58 articles.
1. Amegor O, Bigila D, Oyesola O, Oyesola T, Buseni S. Hematological changes in HIV patients placed on anti retroviral therapy in Markurdi, Benue State of Nigeria. Asian J Epidemiol. 2009;2(4):97–103.
2. World Health Organization. UNAIDS: Global HIV and AIDS statistics– 2023 fact sheets. Available from: www.unaidsorg/en/resources/fact-sheet2023.
3. Ashwood ER, Bruns DE. Tietz fundamentals of clinical chemistry. Saunders Elsevier; 2008.
4. Sinha U, Sengupta N, Mukhopadhyay P, Roy KS. Human immunodeficiency virus endocrinopathy. Indian J Endocrinol Metabol. 2011;15(4):251.
5. Bhasin S, Singh AB, Javanbakht M. Neuroendocrine abnormalities associated with HIV infection. Endocrinol Metab Clin North Am. 2001;30(3):749–64.