title: Male sexual dysfunction associated with antiretroviral therapy.
abstract: To determine whether treatment with protease inhibitors (PIs) is associated with male sexual dysfunction, we conducted a retrospective, cohort study of 254 adult male PI recipients who received care from the staff-model division of a large managed care organization in New England between 1993 and 1998. After a median of 5.0 years of observation, 80 incident cases of sexual dysfunction were observed. Relative to unexposed individuals, the rate of sexual dysfunction adjusted for confounding was most elevated with use of ritonavir (hazard ratio [HR], 2.83; 95% confidence interval [CI], 1.34-5.97; p =.006) followed by indinavir (HR, 1.69; 95% CI, 0.84-3.37; p =.14), nelfinavir (HR, 1.53; 95% CI, 0.66-3.54; p =.32) and saquinavir (HR, 1.25; 95% CI, 0.53-2.96; p =.60). We conclude that PIs, especially ritonavir, appear to increase the risk of sexual dysfunction.
authors.affiliation: Channing Laboratory, Brigham and Women's Hospital and Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA. acolson@challiance.org
authors.forename: Amy E
authors.initials: AE
authors.lastname: Colson
authors.forename: Marla J
authors.initials: MJ
authors.lastname: Keller
authors.forename: Paul E
authors.initials: PE
authors.lastname: Sax
authors.forename: Parker T
authors.initials: PT
authors.lastname: Pettus
authors.forename: Richard
authors.initials: R
authors.lastname: Platt
authors.forename: Peter W
authors.initials: PW
authors.lastname: Choo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D007172:Erectile Dysfunction / Q000139:chemically induced*; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000009:adverse effects*; D015497:HIV-1; D006801:Humans; D019469:Indinavir / Q000009:adverse effects; D008297:Male; D008329:Managed Care Programs; D008875:Middle Aged; D019888:Nelfinavir / Q000009:adverse effects; D009511:New England; D012189:Retrospective Studies; D019438:Ritonavir / Q000009:adverse effects; D019258:Saquinavir / Q000009:adverse effects
chemical_list: D017320:HIV Protease Inhibitors; D019469:Indinavir; D019888:Nelfinavir; D019258:Saquinavir; D019438:Ritonavir