Longitudinal Changes over 10 years in Free Testosterone among HIV-infected and HIV-uninfected Men.

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Nelson Vergel

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SLAMA, Laurence; JACOBSON, Lisa P.; LI, Xiuhong; PALELLA, Frank J. Jr; MARGOLICK, Joseph B; KINGSLEY, Lawrence A.; WILEY, Dorothy J.; PIALOUX, Gilles; DOBS, Adrian S.; BROWN, Todd T; for the Multicenter AIDS Cohort Study (MACS)

JAIDS Journal of Acquired Immune Deficiency Syndromes
Post Acceptance: August 2015
Background: Aging in males is associated with lower testosterone levels and a decrease in diurnal variation of testosterone secretion. Cross-sectional studies have shown lower than expected testosterone levels among HIV-infected men, but whether age-related changes in serum testosterone differ by HIV serostatus is not known.


Methods: HIV-infected men from the Multicenter AIDS Cohort Study (MACS), age >= 45 years at highly active antiretroviral therapy initiation, who had >= 2 samples from the subsequent 10 years, were matched to HIV-uninfected men by age, race, MACS site, and calendar time of samples. Linear mixed effects regression models were used to determine whether free testosterone (FT) and its rate of change differed by HIV serostatus.


Results: 182 HIV-infected and 267 HIV-uninfected men were included: median age 48.8 years (Interquartile range (IQR); 45.8, 53.4), median numbers of FT measurements per participant 4 (IQR; 3, 5), 65% were drawn in the AM. Mean adjusted FT levels were lower among HIV-infected than HIV-uninfected men in AM samples (-6.1 ng/dL (95% CI: -9.8, -2.4), p=0.001), but not in PM samples (-1.7 ng/dL (-6.0, 2.6), p=0.441). The rate of FT decline with age did not differ by HIV serostatus: 9.2 ng/dL (95% CI: -13.4, -5.0) per 10 years for HIV- infected vs. 7.9 ng/dL (95% CI: -10.2, -5.5) for HIV-uninfected men, p = 0.578.


Conclusion: FT decreased similarly with increasing age regardless of HIV serostatus. The lower AM, but not PM, FT levels among HIV-infected men compared to HIV-uninfected men suggests a loss of diurnal variation in FT among HIV-infected men.
 
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