title: Effects of testosterone administration in human immunodeficiency virus-infected women with low weight: a randomized placebo-controlled study.
abstract: BACKGROUND
  The prevalence of human immunodeficiency virus (HIV) disease is increasing among women, many of whom remain symptomatic with low weight and poor functional status. Although androgen levels may often be reduced in such patients, the safety, tolerability, and efficacy of testosterone administration in this population remains unknown.
  
  
  METHODS
  A total of 57 HIV-infected women with free testosterone levels less than the median of the reference range and weight less than 90% of ideal body weight or weight loss greater than 10% were randomly assigned to receive transdermal testosterone (4 mg/patch) twice weekly or placebo for 6 months. Muscle mass was assessed by urinary creatinine excretion. Muscle function was assessed by the Tufts Quantitative Muscle Function Test. Treatment effect at 6 months was determined by analysis of covariance. Results are mean +/- SEM unless otherwise specified.
  
  
  RESULTS
  At baseline, subjects were low weight (body mass index [calculated as weight in kilograms divided by the square of height in meters] 20.6 +/- 0.4), with significant weight loss from pre-illness maximum weight (18.7% +/- 1.2%), and demonstrated reduced muscle function (upper and lower extremity muscle strength, 83% and 67%, respectively, of predicted range). Testosterone treatment resulted in significant increases in testosterone levels vs placebo (total testosterone: 37 +/- 5 vs -2 +/- 2 ng/dL [1.3 +/- 0.2 vs -0.1 +/- 0.1 nmol/L] [P<.001]; free testosterone: 3.7 +/- 0.5 vs -0.4 +/- 0.3 pg/mL [12.8 +/- 1.7 vs -1.4 vs 1.0 pmol/L] [P<.001]) and was well tolerated, without adverse effects on immune function, lipid and glucose levels, liver function, or body composition or the adverse effect of hirsutism. Muscle mass tended to increase (1.4 +/- 0.6 vs 0.3 +/- 0.8 kg; P =.08), and shoulder flexion (0.4 +/- 0.3 vs -0.5 +/- 0.3 kg; P =.02), elbow flexion (0.3 +/- 0.4 vs -0.7 +/- 0.4 kg; P =.04), knee extension (0.2 +/- 1.0 vs -1.7 +/- 1.3 kg; P =.02), and knee flexion (0.7 +/- 0.5 vs 0.3 +/- 0.7 kg; P =.04) increased in the testosterone-treated compared with the placebo-treated subjects.
  
  
  CONCLUSIONS
  Testosterone administration is well-tolerated and increases muscle strength in low-weight HIV-infected women. Testosterone administration may be a useful adjunctive therapy to maintain muscle function in symptomatic HIV-infected women.
authors.affiliation: Neuroendocrine Unit and Program in Nutritional Metabolism, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Dolan
authors.forename: Stephanie
authors.initials: S
authors.lastname: Wilkie
authors.forename: Negar
authors.initials: N
authors.lastname: Aliabadi
authors.forename: Meghan P
authors.initials: MP
authors.lastname: Sullivan
authors.forename: Nesli
authors.initials: N
authors.lastname: Basgoz
authors.forename: Benjamin
authors.initials: B
authors.lastname: Davis
authors.forename: Steven
authors.initials: S
authors.lastname: Grinspoon
mesh_terms: D000328:Adult; D000728:Androgens / Q000494:pharmacology*; D001823:Body Composition / Q000187:drug effects; D001835:Body Weight; D018791:CD4 Lymphocyte Count; D002149:Energy Intake; D005260:Female; D015658:HIV Infections / Q000276:immunology / Q000503:physiopathology*; D006801:Humans; D018482:Muscle, Skeletal / Q000187:drug effects* / Q000503:physiopathology; D015596:Nutrition Assessment; D013739:Testosterone / Q000494:pharmacology*; D019562:Viral Load
chemical_list: D000728:Androgens; D013739:Testosterone