title: Androgen and gonadotropin patterns differ in HIV-1-infected men who develop lipoatrophy during antiretroviral therapy: a case-control study.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital of Berne and University of Berne, Berne, Switzerland.
authors.forename: D M
authors.initials: DM
authors.lastname: Wunder
authors.forename: C A
authors.initials: CA
authors.lastname: Fux
authors.forename: N A
authors.initials: NA
authors.lastname: Bersinger
authors.forename: N J
authors.initials: NJ
authors.lastname: Mueller
authors.forename: B
authors.initials: B
authors.lastname: Hirschel
authors.forename: M
authors.initials: M
authors.lastname: Cavassini
authors.forename: L
authors.initials: L
authors.lastname: Elzi
authors.forename: P
authors.initials: P
authors.lastname: Schmid
authors.forename: E
authors.initials: E
authors.lastname: Bernasconi
authors.forename: B
authors.initials: B
authors.lastname: Mueller
authors.forename: H
authors.initials: H
authors.lastname: Furrer
mesh_terms: 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
chemical_list: D000728:Androgens; D006062:Gonadotropins