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Endocrine disorders in men infected with human immunodeficiency virus

  • Adrian S. Dobs
    Correspondence
    Requests for reprints should be addressed to Dr. Adrian S. Dobs, The Johns Hopkins School of Medicine, Traylor Building, Room 721, 720 Rutland Avenue, Baltimore, Maryland 21205.
    Affiliations
    Division of Endocrinology and Metabolism, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

    Department of Epidemiology, The Johns Hopkins University of School of Hygiene and Public Health, Baltimore, Maryland, USA
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  • Michael A. Dempsey
    Affiliations
    Division of Endocrinology and Metabolism, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

    Department of Epidemiology, The Johns Hopkins University of School of Hygiene and Public Health, Baltimore, Maryland, USA
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  • Paul W. Ladenson
    Affiliations
    Division of Endocrinology and Metabolism, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

    Department of Epidemiology, The Johns Hopkins University of School of Hygiene and Public Health, Baltimore, Maryland, USA
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  • B. Frank Polk
    Affiliations
    Division of Endocrinology and Metabolism, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

    Department of Epidemiology, The Johns Hopkins University of School of Hygiene and Public Health, Baltimore, Maryland, USA
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      Abstract

      Gonadal, adrenal, and thyroid functions were evaluated in 70 men seropositive for human immunodeficiency virus (HIV) infection, clinically categorized as asymptomatic (n = 19), AIDS-related complex (ARC) (n = 9), or acquired immunodeficiency syndrome (AIDS) (n = 42). Twenty of 40 men (50 percent) with AIDS were hypogonadal. Mean serum testosterone concentrations in both ARC (292 ± 70 ng/dl) and AIDS (401 ± 30 ng/dl) men were significantly less than in asymptomatic (567 ± 49 ng/dl) or normal men (608 ± 121 ng/dl). Of these hypogonadal men, 18 of 24 (75 percent) had hypogonadotropic hypogonadism. Seven of eight hypogonadal men (88 percent) had a normal gonadotropin response to gonadotropin-releasing hormone administration. Hypogonadism correlated with lymphocyte depletion and weight loss. Adrenal cortisol reserve, evaluated by adrenocorticotropin stimulation, was normal in 36 of 39 patients (92 percent) with AIDS. Indices of thyroid function were normal with the exception of one ARC man with a low free thyroxine index. In conclusion, hypogonadism is common in men with HIV infection and may be the first or most sensitive endocrine abnormality.
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