Should Clinician Suspect Hormonal Disturbances at Early Stages of HIV Infection in Males?- A North Indian Study

Despite decades of research, HIV seropositive subjects continue to suffer from myriad complications. Endocrinopathies is one area which has emerged after the advent of HAART for HIV infection. As the life span of these patients has increased and number of HIV positive children is increasing, hormonal imbalances continues to affect patient management. This study was planned to assess whether reproductive hormonal disturbances are present in HAART naive HIV seropositive male subjects attending ART center, PGIMS, Rohtak. A correlation between Hormone levelsTestosterone, Estrogen and Progesterone with CD4+ cell counts was also studied. Fifty three cases were compared with fifty three healthy age matched controls. Cases were segregated into three groups depending upon CD4 cell counts as: Group A-CD4 cell counts <200/mm 3 , Group B-CD4 cell counts 200350/mm 3 , Group C-CD4 cell counts > 350/mm 3 . Controls were placed in Group 4.Mean testosterone level was significantly decreased in male cases in all groups than controls. Significant decrease in testosterone levels in males was seen in comparison between Group 1 vs 4, Group 2 vs 4 , Group 3 vs 4.Estrogen levels were not decreased non-significantly between cases and controls. 78.9% males in group A and 72.2% in group B had Progesterone levels <0.28 ng/ml as compared to 12.5% in group C and 7.5% in controls (p<0.001). Conclusion: reproductive hormones should be assessed in HIV positive males on disease detection for better management.