Androgen and gonadotropin patterns differ in HIV-1-infected men who develop lipoatrophy during antiretroviral therapy: a case-control study.
OBJECTIVE
We compared androgen and gonadotropin values in HIV-infected men who did and did not develop lipoatrophy on combination antiretroviral therapy (cART).


METHODS
From a population of 136 treatment-naïve male Caucasians under successful zidovudine/lamivudine-based cART, the 10 patients developing lipoatrophy (cases) were compared with 87 randomly chosen controls. Plasma levels of free testosterone (fT), dehydroepiandrosterone (DHEA), follicle-stimulating hormone and luteinizing hormone (LH) were measured at baseline and after 2 years of cART.


RESULTS
At baseline, 60% of the cases and 71% of the controls showed abnormally low fT values. LH levels were normal or low in 67 and 94% of the patients, respectively, indicating a disturbance of the hypothalamic-pituitary-gonadal axis. fT levels did not significantly change after 2 years of cART. Cases showed a significant increase in LH levels, while controls showed a significant increase in DHEA levels. In a multivariate logistic regression model, lipoatrophy was associated with higher baseline DHEA levels (P=0.04), an increase in LH levels during cART (P=0.001), a lower body mass index and greater age.


CONCLUSIONS
Hypogonadism is present in the majority of HIV-infected patients. The development of cART-related lipoatrophy is associated with an increase in LH and a lack of increase in DHEA levels.
Wunder
D M
DM
Department of Obstetrics and Gynaecology, University Hospital of Berne and University of Berne, Berne, Switzerland.
Fux
C A
CA
Bersinger
N A
NA
Mueller
N J
NJ
Hirschel
B
B
Cavassini
M
M
Elzi
L
L
Schmid
P
P
Bernasconi
E
E
Mueller
B
B
Furrer
H
H
D000328:Adult; D000728:Androgens / Q000378:metabolism*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D004359:Drug Therapy, Combination; D006062:Gonadotropins / Q000378:metabolism*; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D015497:HIV-1; D039682:HIV-Associated Lipodystrophy Syndrome / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D019562:Viral Load
D000728:Androgens; D006062:Gonadotropins