TESTICULAR DYSFUNCTION IN HUMAN IMMUNODEFICIENCY VIRUS-INFECTED MEN

This review pertains to gonadal function in men with human immunodefic iency virus (HIV) infection, who often exhibit clinical and biochemica l evidence of hypogonadism. Hypogonadotropic hypogonadism appears to b e the most commonly encountered abnormality, although complete anterio r pituitary insufficiency and primary gonadal failure have been report ed. Levels of sex hormone-binding globulin (SHBG) are either unchanged or increased. Plasma levels of estrogens, progesterone, androstenedio ne, dehydroepiandrosterone sulfate (DHEA-S), and prolactin vary. Patho logically, except for involvement by opportunistic infections, no sign ificant abnormality in the hypothalamic-pituitary area has been descri bed, but evidence of orchitis is commonly present. The cause(s) of the se abnormalities remains unclear. The possible factors leading to hypo gonadism in HIV-infected men include HIV infection itself, opportunist ic infections, chronic debilitating illness, and effects of cytokines on the hypothalamic-pituitary-gonadal axis. Further studies are needed to clarify the cause(s) of testicular dysfunction in HIV-infected men and its clinical significance, treatment, relevance to the progressio n of HIV infection, and influence on the immune system. Copyright (C) 1995 by W.B. Saunders Company