A study on hypogonadism in male HIV patients in northeastern part of India.

CONTEXT: After the introduction of highly active antiretroviral therapy (ART), the prevalence of hypogonadism among human immunodeficiency virus (HIV)-infected males is decreasing. AIMS: The aim of this study was (i) to estimate the prevalence of hypogonadism among HIV-infected males and (ii) to determine the risk factors for hypogonadism. SETTINGS AND DESIGN: This was a cross-sectional study undertaken at ART center of a medical Institute. SUBJECTS AND METHODS: The study recruited HIV-infected males aged 18-65 years receiving ART. Patients with any debilitating chronic illness, diabetes mellitus, chronic smokers or alcoholic, currently on opioids, or methadone were excluded from the study. Androgen Deficiency in Aging Male (ADAM) questionnaire was used to screen patients for the possible presence of hypogonadism. For those screened positive on ADAM questionnaire underwent biochemical evaluation for serum total testosterone, luteinizing hormone (LH), and CD4 count. STATISTICAL ANALYSIS USED: The Chi-square test was used to compare different parameters. Pearson's correlation coefficient was used to assess any relationship between CD4 count, LH, and testosterone. P < 0.05 was considered statistically significant. RESULTS: In the study, 426 were initially screened and 120 patients who had probable hypogonadism were further evaluated. The mean age of the patients was 41.61 years. The mean body mass index (BMI) of the patients was 22.47 kg/m2. The mean duration of ART was 6.13 years and the mean CD4 count was 442.63 cells/mm3. Hypogonadism was seen in 20 (23.3%) and majority (85.7%) had secondary hypogonadism. There was significant association between hypogonadism and CD4 count, but no association was found with BMI and duration of ART. CONCLUSIONS: Hypogonadism is seen in 23.3% of HIV-infected males. Majority (85.7%) had secondary hypogonadism. There was significant association of hypogonadism with lower CD4 count.

Penicillium morneffei, an emerging AIDS-related pathogen--a RIMS study.

Twenty-seven HIV-infected patients with penicilliosis were included to study the clinical, laboratory and therapeutic features of HIV-infected patients with disseminated Penicillium marneffei infection. Diagnosis was based on microscopy and culture. CD4 counts were assessed by flow cytometry. Males (23 out of 27) predominated while the ages ranged from 20 to 54 years (mean 31.5 years). The most common manifestations were fever, weight loss, anaemia and skin lesions. CD4 counts were low in all the patients. The response to treatment with intravenous amphotericin B followed by itraconazole was excellent. Penicillium marneffei has become an important opportunistic pathogen of HIV infection in Manipur. Penicilliosis should be considered in a susceptible patient with a non-specific febrile illness, a low CD4 count and molluscum contagiosum-like skin lesions. Early diagnosis and treatment improve survival.