DHEA treatment for HIV+ patients: effects on mood, androgenic and anabolicparameters

The goal of this pilot study was to evaluate the effect of dehydroepiandros terone (DHEA) on depressed mood and fatigue in HIV + men and women, unselec ted for baseline DHEA level. Secondary questions concerned treatment effect s on libido and body cell mass; on serum testosterone levels, and elicitati on of short-term side effects. Treatment consisted of an open-label 8-week trial using DHEA doses from 200 to 500 mg/day. Mood responders were maintai ned for another 4 weeks, then randomized to a double blind placebo controll ed if-week discontinuation trial. Forty-five patients, including six women, entered the trial. Of 32 week 8 completers, mood was much improved in 72%, and 81% were rated responders with respect to fatigue. Response on either parameter was unrelated to baseline serum DHEA level. Twenty-one patients e ntered the double blind discontinuation phase. No differences in relapse ra te between placebo and DHEA groups were observed for either mood or fatigue . Body cell mass increased significantly by week 8, and this improvement wa s maintained throughout the double blind phase for patients in both treatme nt conditions. Libido increased significantly as well. DHEA therapy did not have an effect on CD4 cell count Or on serum testosterone levels in men. I n conclusion, DHEA may be a promising treatment for HIV + patients with dep ressed mood and fatigue, although persistence of response even in placebo-t reated patients during the discontinuation phase leaves unresolved question s. A parallel group double blind clinical trial is indicated as the next st ep to more clearly identify therapeutic efficacy. (C) 1999 Elsevier Science Ltd. All rights reserved.