TESTOSTERONE REPLACEMENT TREATMENT OPTIONS FOR HIV-INFECTED MEN

Hypogonadism is well documented in HIV-infected men, particularly as t hey progress to AIDS and in those with symptoms of wasting. Testostero ne deficiency can be diagnosed with simple laboratory tests, and vario us treatment options exist. The benefits of androgen replacement are w ell documented from a large body of literature and experience with hyp ogonadal men without HIV infection. Hypogonadal men who are given test osterone replacement have improved sexual thoughts and functioning, mo re energy, and improved mood. Generally, quality of life improves with such therapy. Testosterone replacement tends to maintain or improve l ean body mass. The benefit, dose, and timing of testosterone replaceme nt treatment for men with HIV infection, however, are less clear and r equire further study. Appropriate history and a high degree of clinica l suspicion, coupled with relatively simple laboratory measurements, c an confirm the diagnosis of hypogonadism in men with HIV. Various opti ons for testosterone replacement, including injections of testosterone esters and the use of transcutaneous patches, are discussed, as are t he uses of pharmacologic doses of testosterone, primarily for its pote ntial anabolic effect.