Erectile dysfunction, testosterone deficiency, and risk of coronary heart disease in a cohort of men living with HIV in Belgium.

Abstract

INTRODUCTION:

Erectile dysfunction (ED) is more prevalent in men living with HIV (MLHIV) when compared with age-matched HIV-negative men. This may be related to a premature decline in testosterone levels. In the general population, ED has been associated with an increased risk for coronary heart disease (CHD).

AIM:

The aim of this study is to determine the prevalence of ED, testosterone deficiency, and risk of CHD in a cohort of young to middle-aged MLHIV in Belgium.

METHODS:

A cross-sectional, observational study among 244 MLHIV attending the outpatient clinic of the Institute of Tropical Medicine in Antwerp.

MAIN OUTCOME MEASURES:

The short version of the international index of erectile function (IIEF-5) questionnaire diagnosed ED (cutoff score ≤ 21). The 10-year risk score for CHD was calculated. In a subset of men reporting ED, the calculated free testosterone (CFT) was determined using Vermeulen's formula. Testosterone deficiency was defined as CFT <0.22 nmol/L.

RESULTS:

One hundred fifty-one men (61.9%) self-reported ED (median IIEF-5 score: 16 [interquartile range (IQR) 12-19]). In multivariate analysis, only increasing age, but none of the HIV-related parameters, nor any of the individual cardiovascular-risk related parameters, was statistically significantly associated with ED. Eighteen out of the 49 (36.7%) men with ED who received a blood test to assess testosterone levels were diagnosed with testosterone deficiency. The 10-year risk of CHD in the cohort was 4.3% (IQR 3.6-5.7) and was significantly higher in men with ED (5.1%, IQR 4.4-6.6) compared with men without ED (3.1%, IQR 2.5-4.2).

CONCLUSIONS:

This study showed that ED and testosterone deficiency are highly prevalent in young to middle-aged MLHIV and that ED might be associated with an increased risk of CHD. Therefore, healthcare professionals should screen for clinical ED and should consider testing for underlying testosterone deficiency. A clinical diagnosis of ED should trigger a full evaluation of the patient's cardiovascular risk factors, even at younger age.

• Authors: Iris De Ryck, David Van Laeken, Ludwig Apers, Robert Colebunders
• Journal: The journal of sexual medicine (J Sex Med) Vol. 10 Issue 7 Pg. 1816-22 (Jul 2013) ISSN: 1743-6109 [Electronic] Netherlands
• PMID: 23651241 (Publication Type: Journal Article)
• Copyright: © 2013 International Society for Sexual Medicine.

Chemical References

• Testosterone

Topics

• Adult
• Belgium (epidemiology)
• Coronary Artery Disease (epidemiology)
• Cross-Sectional Studies
• Erectile Dysfunction (blood, epidemiology)
• HIV Infections (epidemiology)
• HIV Seropositivity (epidemiology)
• Humans
• Male
• Middle Aged
• Prevalence
• Risk Factors
• Testosterone (blood, deficiency)