Endocrine Abstracts

Introduction: Erectile dysfunction (ED) is common among elderly men and patients suffering from chronic diseases, the latter probably including also HIV infection. No studies, however, compared the prevalence of ED in HIV-infected and -uninfected individuals using the IIEF-15.

Aim: To compare ED prevalence in young-middle aged men with and without HIV infection using the International Index of Erectile Function (IIEF-15) questionnaire.

Methods: We conducted a cross-sectional, observational, controlled study on 444 HIV-infected and 71 -uninfected men. The IIEF-15 questionnaire was used to assess ED. A cutoff score of <25 of the erectile domain was used to diagnose ED. Serum testosterone, demographic and anthropometric (weight, height, BMI) characteristics were obtained from all participants. Statistics included the T-test, the Fisher’s test, univariable and multivariable logistic regression and univariate and multivariate Spearman’s correlation analysis.

Results: HIV-uninfected group was significantly younger than HIV-infected and presented a higher BMI (P<0.001). The prevalence of mild, moderate, and severe ED was higher in HIV-infected than in HIV-uninfected men of all decades of age (Fig. 1). In univariate analysis, HIV infection was associated with ED (OR=34.19, P<0.001). In multivariable logistic regression analysis, HIV infection remained the strongest predictors of ED (OR=42.26, P<0.001) followed by hypogonadism, after adjusting for age and BMI.

Conclusions: This study demonstrates a clear association between ED and HIV infection, after adjusting for age and BMI. Other than HIV infection, hypogonadism was associated with ED. In addition, the prevalence of ED was higher in HIV-infected than in HIV-uninfected men, in all decades of age. The early onset of ED in HIV-infected men could be considered a peculiar clinical hallmark of HIV and confirms precocious aging in these patients. ED should be of concern to clinicians when managing HIV-infected men even if the latter are young or middle aged.

Figure 1 Prevalence of erectile dysfunction in HIV-infected and HIV-uninfected patients in all decades of age.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.