Generic placeholder image

Current HIV Research

Editor-in-Chief

ISSN (Print): 1570-162X
ISSN (Online): 1873-4251

Research Article

Prevalence of and Risk Factors for Low Free Testosterone Levels in Japanese Men with Well-controlled Human Immunodeficiency Virus Infection

Author(s): Yusuke Yoshino*, Ichiro Koga, Yoshitaka Wakabayashi, Takatoshi Kitazawa and Yasuo Ota

Volume 18, Issue 5, 2020

Page: [381 - 386] Pages: 6

DOI: 10.2174/1570162X18666200720000344

Price: $65

Abstract

Background: The change in the prevalence of hypogonadism with age in men with human immunodeficiency virus (HIV) infection is subject to debate.

Objective: To address this issue, we diagnosed hypogonadism based on serum levels of free testosterone (fTST) rather than total testosterone which is thought to be an inaccurate indicator. We also determined the relationship between age and fTST levels and identified risk factors for hypogonadism in men with HIV infection.

Methods: We retrospectively reviewed fTST levels and associated clinical factors in 71 wellcontrolled HIV-infected men who were treated at Teikyo University Hospital between April 2015 and March 2016 and who had data available on serum fTST levels, measured >6 months after starting antiretroviral therapy. fTST was measured using radioimmunoassay on blood samples collected in the morning. Risk factors for hypogonadism were identified using Welch’s t-test and multiple regression analysis.

Results: The men had a mean (± standard deviation) age of 47.4 ± 13.6 years, and mean (± standard deviation) serum fTST level of 13.0 ± 6.1 pg/mL. Fifteen (21.1%) men had hypogonadism based on a fTST <8.5 pg/mL. Serum fTST levels significantly decreased with age (−0.216 pg/mL/year). Older age and low hemoglobin levels were identified as risk factors for hypogonadism.

Conclusion: The men in the study experienced a more rapid decline in fTST levels with age than men in the general population (−0.161 pg/mL/year). Serum fTST levels in men with HIV infection should be monitored, especially in older men and those with low hemoglobin levels.

Keywords: HIV, free testosterone, hypogonadism, radioimmunoassay, ageing, hemoglobin.

« Previous
Graphical Abstract
[1]
Schubert M, Jockenhövel F. Late-onset hypogonadism in the aging male (LOH): definition, diagnostic and clinical aspects. J Endocrinol Invest 2005; 28(3)(Suppl.): 23-7.
[PMID: 16042356]
[2]
Dandona P, Rosenberg MT. A practical guide to male hypogonadism in the primary care setting. Int J Clin Pract 2010; 64: 682-96.
[http://dx.doi.org/10.1111/j.1742-1241.2010.02355.x]
[3]
Christeff N, Gharakhanian S, Thobie N, Rozenbaum W, Nunez EA. Evidence for changes in adrenal and testicular steroids during HIV infection. J Acquir Immune Defic Syndr 1992; 5(8): 841-6.
[http://dx.doi.org/10.1097/00126334-199208000-00012] [PMID: 1387684]
[4]
Raffi F, Brisseau JM, Planchon B, Rémi JP, Barrier JH, Grolleau JY. Endocrine function in 98 HIV-infected patients: a prospective study. AIDS 1991; 5(6): 729-33.
[http://dx.doi.org/10.1097/00002030-199106000-00013] [PMID: 1883545]
[5]
Wanke CA, Silva M, Knox TA, Forrester J, Speigelman D, Gorbach SL. Weight loss and wasting remain common complications in individuals infected with human immunodeficiency virus in the era of highly active antiretroviral therapy. Clin Infect Dis 2000; 31(3): 803-5.
[http://dx.doi.org/10.1086/314027] [PMID: 11017833]
[6]
Araujo AB, O’Donnell AB, Brambilla DJ, et al. Prevalence and incidence of androgen deficiency in middle-aged and older men: estimates from the Massachusetts Male Aging Study. J Clin Endocrinol Metab 2004; 89(12): 5920-6.
[http://dx.doi.org/10.1210/jc.2003-031719] [PMID: 15579737]
[7]
Monroe AK, Dobs AS, Palella FJ, Kingsley LA, Witt MD, Brown TT. Morning free and total testosterone in HIV-infected men: implications for the assessment of hypogonadism. AIDS Res Ther 2014; 11: 6.
[http://dx.doi.org/10.1186/1742-6405-11-6.]
[8]
Rochira V, Zirilli L, Orlando G, Santi D, Brigante G, Diazzi C, et al. Premature decline of serum total testosterone in HIV-infected men in the HAART-era. PLoS One 2011; 6e28512
[http://dx.doi.org/10.1371/journal.pone.0028512]
[9]
Crum-Cianflone NF, Bavaro M, Hale B, et al. Erectile dysfunction and hypogonadism among men with HIV. AIDS Patient Care STDS 2007; 21(1): 9-19.
[http://dx.doi.org/10.1089/apc.2006.0071] [PMID: 17263654]
[10]
Lachâtre M, Pasquet A, Ajana F, Soudan B, Lion G, Bocket L, et al. HIV and hypogonadism: a new challenge for young-aged and middle-aged men on effective antiretroviral therapy. AIDS 2017; 31: 451-3.
[http://dx.doi.org/10.1097/QAD.0000000000001348]
[11]
Yoshino Y, Koga I, Misu K, Seo K, Kitazawa T, Ota Y. The prevalence of low serum free testosterone and the short-term effect of anti-retroviral therapy in male Japanese treatment-naive HIV patients. J Infect Chemother 2019; 25: 318-21.
[http://dx.doi.org/10.1016/j.jiac.2018.09.007.]
[12]
Iwamoto T, Yanase T, Horie H, Namiki M, Okuyama A. Late-onset hypogonadism (LOH) and androgens: validity of the measurement of free testosterone levels in the diagnostic criteria in Japan. Int J Urol 2009; 16: 168-74.
[http://dx.doi.org/10.1111/j.1442-2042.2008.02203.x.]
[13]
Iwamoto A, Taira R, Yokomaku Y, Koibuchi T, Rahman M, Izumi Y, et al. The HIV care cascade: Japanese perspectives. PLoS One 2017; 12e0174360
[http://dx.doi.org/10.1371/journal.pone.0174360.]
[14]
Namiki M, Akaza H, Shimazui T, Ito N, Iwamoto T, Baba K. Clinical practice manual for late-onset hypogonadism syndrome. Int J Urol 2008; 15: 377-88.
[http://dx.doi.org/10.1111/j.1442-2042.2008.02010.x]
[15]
Goulet JL, Fultz SL, Rimland D, Butt A, Gibert C, Rodriguez-Barradas M. Aging and infectious diseases: do patterns of comorbidity vary by HIV status, age, and HIV severity? Clin Infect Dis 2007; 45: 1593-601.
[http://dx.doi.org/10.1086/523577.]
[16]
Guaraldi G, Orlando G, Zona S, Menozzi M, Carli F, Garlassi E, et al. Premature age-related comorbidities among HIV-infected persons compared with the general population. Clin Infect Dis 2011; 53: 1120-6.
[http://dx.doi.org/10.1093/cid/cir627.]
[17]
Shin YS, You JH, Cha JS, Park JK. The relationship between serum total testosterone and free testosterone levels with serum hemoglobin and hematocrit levels: a study in 1221 men. Aging Male 2016; 19(4): 209-14.
[http://dx.doi.org/10.1080/13685538.2016.1229764] [PMID: 27750487]
[18]
Bachman E, Travison TG, Basaria S, et al. Testosterone induces erythrocytosis via increased erythropoietin and suppressed hepcidin: evidence for a new erythropoietin/hemoglobin set point. J Gerontol A Biol Sci Med Sci 2014; 69(6): 725-35.
[http://dx.doi.org/10.1093/gerona/glt154] [PMID: 24158761]
[19]
Moreno SA, Shyam A, Morgentaler A. Comparison of free testosterone results by analog radioimmunoassay and calculated free testosterone in an ambulatory clinical population. J Sex Med 2010; 7: 1948-53.
[20]
Iwamoto T, Yanase T, Koh E, Horie H, Baba K, Namiki M. Reference ranges of total serum and free testosterone in Japanese male adults. Japan J Urol 2004; 95: 751-60.
[http://dx.doi.org/10.5980/jpnjurol1989.95.751]
[21]
Cooke RR, McIntosh JE, McIntosh RP. Circadian variation in serum free and non-SHBG-bound testosterone in normal men: measurements, and simulation using a mass action model. Clin Endocrinol (Oxf) 1993; 39(2): 163-71.
[http://dx.doi.org/10.1111/j.1365-2265.1993.tb01769.x] [PMID: 8370129]
[22]
Huhtaniemi I, Forti G. Male late-onset hypogonadism: pathogenesis, diagnosis and treatment. Nat Rev Urol 2011; 8(6): 335-44.
[http://dx.doi.org/10.1038/nrurol.2011.47] [PMID: 21502974]
[23]
Shores MM, Smith NL, Forsberg CW, Anawalt BD, Matsumoto AM. Testosterone treatment and mortality in men with low testosterone levels. J Clin Endocrinol Metab 2012; 97(6): 2050-8.
[http://dx.doi.org/10.1210/jc.2011-2591] [PMID: 22496507]
[24]
Grulich AE, van Leeuwen MT, Falster MO, Vajdic CM. Incidence of cancers in people with HIV/AIDS compared with immunosuppressed transplant recipients: a meta-analysis. Lancet 2007; 370(9581): 59-67.
[http://dx.doi.org/10.1016/S0140-6736(07)61050-2] [PMID: 17617273]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy