Wednesday, November 20, 2013

Testosterone supplementation for persons with HIV infection

Testosterone supplementation is extensively used for persons with HIV infection. A latest chart review of the electronic medical register at the San Francisco General Hospital HIV clinic indicated that approaching 11% of 1,400 man patients were receiving androgen replacement. In the years when there was no effectual treatment for HIV, testosterone was useful for the treatment of wasting attributable to HIV. In 2011, however, when the great majority of patients with HIV can expect to have improved health and life expectancy through effectual treatment with ART, even in the proximity of medication-resistant HIV, it is time to reexamine the risks and benefits of extensive-term testosterone supplementation for HIV-infected men. Hypogonadism, defined as decreased testicular production of testosterone, occurs commonly with HIV infection and chronic disorder. However, establishing an accurate laboratory confirmation of a correct hypogonadal state can be challenging and, if not done appropriately, may lead to a mistaken diagnosis of hypogonadism and unbefitting testosterone replacement. Total testosterone should be regulated in the morning, when testosterone levels are highest. A low totality testosterone measuring warrants repeat testing for confirmation. Random non-morning testosterone measurements may not be exact indicators of hypogonadism.

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