DIFFERENCES IN ANDROGENS OF HIV-POSITIVE PATIENTS WITH AND WITHOUT KAPOSI-SARCOMA

Aim-Since most forms of Kaposi sarcoma are much more common in men tha n in women, the aim of this study was to examine serum concentrations of sex steroids in HIV positive men with and without Kaposi sarcoma. M ethods-Blood samples from 34 HIV positive men without Kaposi sarcoma ( KS-) and 28 with Kaposi sarcoma (KS+) and from 35 HIV negative men (co ntrols) were analysed for adrenal and gonadal steroids. Further analys is was done in subgroups classified by CD4 lymphocyte counts. Results- KS+ patients had significantly higher serum dehydroepiandrosterone (DH EA) and testosterone concentrations than the KS- patients, and their D HEA, DHEA sulphate, testosterone, and androstenedione values were high er than in the controls. The KS+ patients with more than 500 CD4 lymph ocytes per mm(3) had significantly higher serum DHEA, DHEA sulphate, a nd testosterone than the KS-patients with the same CD4 counts; those w ith 500-200 CD4 cells/mm(3) had higher serum DHEA and testosterone tha n the equivalent KS- men; and those with <200 CD4 cells/mm(3) had rais ed DHEA only compared with KS- men. Both KS+ and KS- men had higher se rum progesterone and oestradiol than the controls. Glucocorticoids wer e not significantly altered. Conclusions-The high androgen levels in K S+ patients, particularly in the early stages of the disease (>500 CD4 cells/mm(3)), may affect the immune system by inducing an abnormal cy tokine profile, or by increasing T8 proliferation and activation, or b oth. This raises the question of the relationship between androgens an d Kaposi sarcoma.