ECE2020 Audio ePoster Presentations Reproductive and Developmental Endocrinology (79 abstracts)
Testosterone (T) is poorly related to sexual desire and Erectile Dysfunction (ED) in Young/Middle Aged Human immunodeficiency virus (HIV)-Infected Men
Sara De Vincentis 1,2 , Maria Chiara Decaroli 1,2 , Chiara Diazzi 2 , Fabio Morini 1 , Davide Bertani 1 , Flaminia Fanelli 3 , Marco Mezzullo 3 , Daniele Santi 1,2 , Giulia Tartaro 1,2 , Enrica Baraldi 4 , Simonetta Tagliavini 4 , Uberto Pagotto 3 , Giovanni Guaraldi 5 & Vincenzo Rochira 1,2
1Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Modena, Italy; 2Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy; 3Endocrinology Unit and Center for Applied Biomedical Research (CRBA), Department of Medical and Surgical Sciences, University of Bologna – S. Orsola-Malpighi Hospital, Bologna, Italy; 4Department of Laboratory Medicine and Anatomy Pathology, Azienda USL of Modena, Modena, Italy; 5Multidisciplinary Metabolic Clinic, Unit of Infectious Diseases, University of Modena and Reggio Emilia, Modena, Italy
Background: ED is highly prevalent in HIV-infected men. T leads sexual behavior in men, but preliminary data suggests that ED is poorly related to serum T in HIV--infected men.
Aim: To explore the relationship between sexual function and gonadal function in young/middle-aged HIV-infected men.
Methodology: Prospective, cross-sectional, observational study on HIV-infected men (age <50 years). Serum TT was assessed by the gold standard LC-MS/MS. Sex hormone-binding globulin (SHBG) was measured by chemiluminescent immunoassay and calculated free T (cFT) was obtained by Vermeulen equation. Biochemical hypogonadism was defined as TT levels below 320 ng/dl and/or cFT levels below 64 pg/ml. The validated International Index of Erectile Function (IIEF)-15 questionnaire was used to identify the presence of ED (score <25) and its degree. IIEF-5 was performed to check if it is reliable as IIEF-15 in this setting.
Statistical analysis: Continuous and categorical variables were compared using ANOVA univariate and Chi-Square test. Correlations were performed using linear regression models.
Results: 315 consecutive HIV-infected men were enrolled (mean age 45.3 ± 5.3 years; mean duration of HIV-infection 16.3 ± 8.8 years). A total of 187 patients (59.7%) had ED at IIEF-15; 59 patients (31.5%) presented a severe form of ED (score <10). Considering gonadal function, 35 patients (11.1%) had T deficiency. Scores of EF (P = 0.039) and sexual desire (P = 0.015) domains were higher in hypogonadal than eugonadal men. Accordingly, the prevalence of ED raised to 71.4% among hypogonadal men. By considering ED severity, patients with severe ED showed a longer duration of infection (P = 0.039) and lower cFT levels (P = 0.041) than patients with mild ED. No difference was found for age (P = 0.224) and TT levels (P = 0.110). IIEF-15 score was inversely related to duration of infection (R2 = 0.030, beta = −0.173, P = 0.002) and patients’ age (R2 = 0.020, beta = −0.140, P = 0.013).No significant correlation was found between IIEF-15 score and total T (P = 0.236) and cFT (P = 0.126). The erectile function domain at IIEF-15 directly correlated with IIEF-5 score (R2 = 0.545, beta = 0.778, P < 0.001).
Conclusions: In our HIV-cohort of young/middle-aged men, the prevalence of ED and T deficiency were high being of 60% and 11%, respectively. Serum TT and cFT did not correlate with sexual function parameters, even though sexual desire was lower in men with hypogonadism. ED seems to be better predicted by other factors, such as the duration of infection in this clinical setting, rather than the gonadal status. Furthermore, IIEF-5 seems to be as reliable as IIEF-15 for ED diagnosis in HIV-infected men.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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