Sexual dysfunction associated with protease inhibitor containing highly active antiretroviral treatment

Background: A high proportion of individuals receiving highly active antire troviral treatment (HAART) complain of sexual dysfunction (SD), encompassin g a lack of desire or erectile dysfunction. Objective: To determine whether SD was associated with particular component s of the HAART regimens and to identify risk factors for the development of SD in patients on HAART. Methods: A survey among patients with HIV infection using an anonymous ques tionnaire was conducted in 10 European countries between December 1998 and December 1999. A total of 904 individuals currently receiving antiretrovira l agents were included in the analyses. Results: A decrease in sexual interest was significantly more frequently re ported by subjects (men and women) using HAART containing protease inhibito rs (PI) (308/766, 40%), compared with PI-naive patients (22/138, 16%; OR 3. 55; 95% CI 2.15-5.89). In addition, a significantly larger number of PI-exp erienced men reported a decrease in sexual potency (216/628, 34%) compared with PI-naive men (12/99, 12%; OR 2.56; 95% CI 1.33-5.03). In multivariate analyses the following factors were associated with a decrease in sexual in terest: a current PI-containing regimen, a history of a PI regimen, symptom atic HIV infection, age and homosexual contact as HIV transmission mode. Fa ctors associated with a decrease in sexual potency were: current use of a P I-containing regimen, symptomatic HIV disease, age and the use of tranquill isers. Conclusion: SD appears to be a common side-effect of HAART regimens contain ing a PI. The potential association between SD and other side-effects of HA ART, such as lipodystrophy syndrome and neuropathy, should be investigated further. (C) 2001 Lippincott Williams & Wilkins.