The cause of hypogonadism in HIV is unknown. Researchers continue to investigate the reasons behind the increased incidence of hypogonadism, as well as ways to improve and standardize diagnosis and treatment and to determine which patients with HIV are at highest risk for hypogonadism.
“Hypogonadism among men infected with HIV is nothing new and was very common before there was effective ART,” Todd T. Brown, MD, PhD, associate professor of medicine in the division of endocrinology and metabolism at Johns Hopkins University, told Endocrine Today. “Testosterone replacement was an important treatment for AIDS-related wasting before there was effective ART. Now we’re seeing sort of a different ‘flavor’ because most people are on effective ART, but the question remains about what’s happening to their testosterone levels.”
In an interview with Endocrine Today, Steven K. Grinspoon, MD, professor of medicine at Harvard Medical School and director of the program in nutritional metabolism and clinical director of the neuroendocrine clinical center at Massachusetts General Hospital, said in the early days of HIV, before ART, patients with HIV were often chronically ill with opportunistic infections and low weight, and were often hypogonadal.
“It was unclear if the hypogonadism was related to HIV per se or associated illness, but the prevalence was fairly high — typically around 50%,” Grinspoon said in an interview. “More recent data suggest that the prevalence is about 20%, but we’re not 100% sure what the number is.”
