Polycythemia vera in a patient with acquired immunodeficiency syndrome

Testosterone replacement therapy and polycythemia in HIV-infected patients

We conducted a case-control study to assess testosterone use as a primary risk factor for polycythemia in 21 HIV-infected men. Any testosterone use within 2 months of first elevated hemoglobin was associated with polycythemia (matched odds ratio 6.55; 95% confidence interval 1.83-23.4; P = 0.004) and intramuscular administration demonstrated a stronger association than topical use. No adverse cardiovascular or thrombotic events were observed. HIV-infected patients taking testosterone should undergo routine hematologic monitoring with adjustment of therapy when appropriate.