Dehydroepiandrosterone sulfate (DHEAS) and testosterone: Relation to HIV illness stage and progression over one year

This study explored associations between serum dehydroepiandrosterone sulfa te (DHEAS), free and total testosterone levels, and HIV illness markers, in cluding viral load, and the behavioral problems of fatigue and depressed mo od, Subjects were 169 HIV-positive men evaluated at baseline, 6, and 12 mon ths for levels of DHEAS, total and free testosterone, HIV RNA, CD4, HIV sym ptoms, opportunistic illnesses, fatigue, and depression. Men with AIDS (N = 105), compared with men with less advanced illness, had lower mean levels of DHEAS. Baseline DHEAS was positively correlated with CD4 count, HIV symp tom severity, and was inversely correlated with HIV RNA. Baseline DHEAS bel ow the laboratory reference range (96 mu g/dl) was associated with history of opportunistic infections and malignancies (adjusted odds ratio [OR], 4.4 ; 95% confidence interval [CI], 1.9-10.4) and with incidence of these compl ications or death over 1 year (adjusted OR, 2.6; 95% CI, 1-7.2). Initiating protease inhibitor combination therapy was associated with an increase in DHEAS over 6 months. Free testosterone was inversely correlated with HIV RN A, but there were no other significant associations between testosterone an d HIV illness markers. No hormone was related to fatigue or depression. Thi s study confirms that low serum DHEAS is associated with HIV illness marker s, including viral load, and carries negative prognostic value. Further, pr otease inhibitor therapy may result in increased circulating DHEAS.